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The subject matter of the following pages was originally addressed, 
in the form of a letter, to the Chief Magistrate of the city. Its prepara* 
tion was undertaken, principally with a view to an exposition of the 
true principles which should regulate the action of public bodies, in 
matters relating to the health of cities, in a knowledge of, or concern 
for, which, recent events had shown our own municipal legislature, to 
be somewhat deficient. Appreciating fully the importance of its &cts 
and suggestions, the Mayor transmitted the communication to a co- 
ordinate branch of the City Government, recommending it to their serious 
attention. After several weeks' deliberation upon it, the committee to 
whom it was referred arrived at the conclusion, embodied in the follow- 
ing language quoted from their report : " Your committee do not profess 
to be judges of the subject, or in other words, they do not think it proper 
at this time, to go into such a measure," and they recommended that 
the paper be returned to its author. Under these circumstances no other 
course remained, in order to obtain for the subject its merited attention, 
than to lay the communication before the pubhc, as was done in a free 

The writer embraces this occasion to acknowledge his obligations to 
the several professional gentlemen, and Tract agents, who have so kindly 
aided him in preparing this expose of the sanitary condition and wants 
of this city ; — to Hon. James Harper, for his complimentary though un- 
availing recommendation of the paper to the Common Council, as well 
as to him and to Hugh Maxwell, Andrew Boardman, Gen. James Tall- 
madge, Wm. B. Crosby, Peter Cooper, Horatio Allen, T. G. Mower, 
M. D. U. S. A., James J. Mapes,Hon. Wm. T. McCoun, J. L. Mott, 
Wm. Shotwell, Josiah Rich, and Wager Hull, for the voluntary and libe- 
ral assistance rendered by them, in bringing it before the public, in its 
present form. Thanks are due also to the American Institute for the 
ree use of their Repository, for the delivery of the discourse. 

272 £ast Broadway, January, 1845, 


Objects briefly stated, 2 

Distinction between Public Health and Individual Health, - - - 3 

System of Tenantage of the Poor, 6 

Arrangements of dwellings of the Poor, 7 

Cellars as residences — their influences, 8 

Ventilation — ^Amount of air necessary for each person, - - - - 10 

Number of Sick Paupers — Greater proportion of Females, - - - 13 

Letter from John A. Swett, M. D. 15 

do. do. Stephen Wood, M. D 16 

do. do. B. McCready, M. D. - - 18 

Scrofula — ^the prevailing disease, 19 

Respective influences of food and air, 20 

Number dying at certain ages, 21 

Comparative chances of life in different Occupations, - - - - «< 

Grovemment a party to the degradation of its subjects, - - - 23 

Influence of ill-health on morals, 24 

Queries addressed to the Tract Missionaries, 25 

Ajiswer from Hev. G. Hatt, «« 

" « J. B. Horton, 27 

" «« Samuel Russel, Jr 30 

" " John H. Bulen, 32 

« « Rev. Isaac Orchard, 34 

Dependence of the Community on the Labor of its Members, - - 39 

Extract from Hon. Horace Mann, " 

Present External and Internal Health Police, 41 

Late appointment of City Inspector, and memorial of Medical Profession, - 43 

Suggestion of a new Arrangement for, and Proper Duties of a Sanitary Police, 44 

Fresn air a preventive of Intemperance, 49 

Medical Education in an Ofllcer of Health necessary, - - - - 50 

Letter from R. K. Hoffman, M. D. - - - - - - - 51 

Sewerage — ^Burial Places, &c. — Study of causes of disease, - - - 52 

Study of Physiology recommended, ---.--- 55 


The subject matter of the following pages was originally addressed, 
in the form of a letter, to the Chief Magistrate of the city. Its prepara- 
tion was undertaken, principally with a view to an exposition of the 
true principles which should regulate the action of public bodies, in 
matters relating to the health of cities, in a knowledge of, or concern 
for, which, recent events had shown our own municipal legislature, to 
be somewhat deficient. Appreciating fully the importance of its &cts 
and suggestions, the Mayor transmitted the communication to a co- 
ordinate branch of the City Government, recommending it to their serious 
attention. After several weeks' deliberation upon it, the committee to 
whom it was referred arrived at the conclusion, embodied in the follow- 
ing language quoted from their report : <' Your committee do not profess 
to be judges of the subject, or in other words, they do not think it proper 
at this time, to go into such a measure," and they recommended that 
the paper be returned to its author. Under these circumstances no other 
course remained, in order to obtain for the subject its merited attention, 
than to lay the communication before the public, as was done in a free 

The writer embraces this occasion to acknowledge his obligations to 
the several professional gentlemen, and Tract agents, who have so kindly 
aided him in preparing this expose of the sanitary condition and wants 
of this city ; — to Hon. James Harper, for his complimentary though un- 
availing recommendation of the paper to the Common Council, as well 
as to him and to Hugh Maxwell, Andrew Boardman, Gen. James Tall- 
madge, Wm. B. Crosby, Peter Cooper, Horatio Allen, T. G. Mower, 
M. D. U. S. A., James J. Mapes,Hon. Wm. T. McCoun, J. L. Mott, 
Wm. Shotwell, Josiah Rich, and Wager Hull, for the voluntary and libe- 
ral assistance rendered by them, in bringing it before the public, in its 
present form. Thanks are due also to the American Institute for the 
ree use of their Repository, for the delivery of the discourse. 

272 Fast Broadway, January, 1845, 



Objects briefly stated, 2 

Distinction between Public Health and Individual Health, - - - 3 

System of Tenantage of the Poor, 6 

Arrangements of dwellings of the Poor, 7 

Cellars as residences — ^their influences, 8 

Ventilation — ^Amount of air necessary for each person, - - - - 10 

Number of Sick Paupers — Greater proportion of Females, - - - 13 

Letter from John A. Swett, M. D. 15 

do. do. Stephen Wood, M. D. 16 

do. do. B. McCready, M. D. 18 

Scrofula — the prevailing disease, 19 

Respective influences of food and air, 20 

Number dying at certain ages, 21 

Comparative chances of life in different Occupations, ---.«< 

Grovemment a party to the degradation of its subjects, - - - 23 

Influence of ill-health on morals, 24 

Queries addressed to the Tract Missionaries, 25 

Ajiswer from Rev. G. Hatt, «« 

«« « J. B. Horton, 27 

" " Samuel Russel, Jr 30 

" " John H. Bulen, 32 

" « Rev. Isaac Orchard, 34 

Dependence of the Community on the Labor of its Members, - - 39 

Extract from Hon. Horace Mann, " 

Present External and Internal Health Police, - ... - 41 

Late appointment of City Inspector, and memorial of Medical Profession, - 43 

Suggestion of a new Arrangement for, and Proper Duties of a Sanitary Police, 44 

Fresh air a preventive of Intemperance, 49 

Medical Education in an Officer of Health necessary, - - - . 50 

Letter from R. K. Hoffman, M. D. - 51 

Sewerage — ^Burial Places, &c. — Study of causes of disease, - - - 52 

Study of Physiology recommended, - - - -- - - 65 


07 THE 


No duty can engage the attention of the magistracy of a city or 
state, more dignified in itself, more beneficial to the present seneration^ 
or more likely to prove useful to fheir descendants, than that of prO' 
curing and maintaining a sound state of the public health. 

Of the three objects contemplated in the Declaration of Independence 
as necessary to be secured by government, the first named is '^ Life.'^ 
Higher purposes cannot be conceived for which governments should 
be instituted. 

As upon the condition of health of an individual are based his physi^ 
cal and mental strength, his ability for self-maintenance, his personal 
happiness, and that of others dependent on him, and also his usefulness 
to his family, to the community and his country ; and as the commu- 
nity depends for its prosperity upon the performances of its members, 
individually and collectively, in the measure of influence committed to 
them respectively, so does the health of the people affect the capacity 
and interests of the state. , 

Aa upon the individual, when sick, falls an increased pecuniary bur-^ 
den, with (in general) a suspension of income, so upon the state or 
city, must rest, not only the expenses of removing an unsound condi- 
tion of public health, but also, firom the attendant loss of character^ a 
diminution of its resources. 

When individuals of the pauper class are ill, their entire support, 
and perchance that of the whole &mily, falls upon the community. 
From a low state of general health, whether in an individual or in 
numbers, proceed diminished energy of body and of mind, and a viti- 
ated moral perception, the frequent precursor of habits and deeds, which 
give employment to the officers of police, and the ministers of justice. 

These, among other considerations, together with the recent ex- 
pression by the chief magistrate of the city of his interest in the sani^ 
tary condition of his constituency, by the recommendation to the Com- 
mon Council of a measure of no ordinary importance to their welfare 


and comfort,* induce me to urge attention to a measure of improvement 
which has long impressed my mind, as one, above all others, demand- 
ing the action of the City Government. 

When it was my pleasure, as it was my duty, in 1842 and '43, to 
devote my small energies to the sanitary improvement of my native 
city, stimulated by the consciousness of being engaged in a work here- 
tofore untried in any systematic form, and promising results of the 
highest and most enduring interests to my fellow citizens, 1 seized the 
occasion to recommend to the Common Council the adoption of a mea- 
sure of Health Police, which 1 thought of serious necessity. It was 
the last effort I was enabled to make upon the subject, before I was 
again consigned to the private ranks, by removal from office. I then 
hoped to see the small beginning 1 had made, grow into shape and use- 
fulness under the fostering hands of whoever might be my successors. 
But, in common with all who had the subject so much at heart, I have 
been disappointed ; for not only was it untouched, but the seeds which 
1 had planted were neglected, and suffered to rot in the ground. Ano- 
ther political revolution brought with it the hope, strengthened by loud 
professions of municipal reform, that at last the day was certain and at 
nand, when this subject would be no longer allowed to slumber, but 
would be regarded as one of the most urgent, and among the first, of 
the objects ol attention by the new Common Council. The expecta- 
tions of the public could not be mistaken ; but an erroneous apprecia- 
tion, or an entire misconception, in some quarter, of the duties and re- 
quisite qualifications of an officer of health, has deferred the hopes en- 
tertained of the further prosecution of this interesting, and vitally im- 
portant, sanitary reform. 

The desire which stimulated me in former days was, however, not 
suffered to sleep in my bosom ; a year's reflection, and daily and more 
extended observation, have not only confirmed my confidence in the 
feasibility, but increased the conviction of the necessity, of the measure 
I had proposed, and they have enabled me to nKxiify, enlarge, and illus- 
trate tne plan, while the determination displayed by the new chief 
magistrate to do fUs share of the reforms promised, has inspired me 
afiresh with the hope that the present might he a fovourable time for a 
renewed presentation of my favourite design. 

It is a measure of Sanitary Reform. It is designed to relieve the 
city of a part of the heavy burden of sickness and mortality, which now 
oppresses its population, more especially that portion least able to re- 
lieve themselves, and most requiring the interposition and protection of 
Law. It will be seen to be a measure of humanity, of justice to the 
poor, of safety to the whole people, and of economy to the public 

The objects of this communication, briefly stated, are these ; — 1st, to 
show that there is an immense amount of sickness, physical disability, 
and premature mortality, among the poorer classes ; — ^2d, that these 
are, to a large extent, unnecessary, being in a great degree the results 

* Public Baths. 


of causes which are removeahle; — dd, that these physical evils are 
productive of moral evils of great magnitude and number, and which, if 
considered only in a pecuniary point of view, should arouse the govern- 
ment and individuals to a consideration of the best means for their re* 
lief and prevention ; and 4th, to suggest the means of alleviating 
these evils and preventing their recurrence to so great an extent. 

Before proceeding to the explanation of the subject, it is necessary to 
understand the distinction between Public Health and Individual Health. 
In some senses these are different, in others they are similar, and have 
an intimate connexion. The difference depends chiefly on the cause 
being personal or general. Thus an individual may be made sick by 
causes which a6^ct no one else, as in Dyspepsia, Ophthalmia, Rheuma- 
tism, &c., and yet even these diseases, personal and peculiar as they 
seem to be, will sometimes be found dependent upon causes which 
aflect large numbers at the same time. For instance, the well water, 
which we have heretofore been obliged to drink, was the frequent 
cause of Dyspepsia, and some other complaints. Ophthalmia sometimes 
prevails extensively in asylums and hospitals, and at the Long Island 
farms it has several times proved a scourge, while both it and Rheu- 
matism are frequent among the residents of damp and dark cellars. 

Consumption is an instance of a disease of individual character, 
but which is, to a veiy considerable extent, in its commencement and 
progress, influenced by the circumstances surrounding the patient. The 
same may be said of Scrofula especially, of which, indeed, many other 
diseases are only accompaniments or symptoms. 

While there is scarcely a disease which may not at times become 
epidemic or endemic, theie are some more strikingly and uniformly so ; 
ex. gr. : Fevers of various kinds, as Yellow, Typhus, Intermittent, 
and likewise Small Pox, Scarlatina, Cholera, Measles, &c. 

Summer is the season generally deemed most prolific in diseases ; 
the cause usually assigned for this is the heat of the weather acting 
upon animal and vegetable matter, producing more extensive and rapid 
decomposition, the gases from which are generally imagined to be so 
destructive to health and life. It is true that certain diseases prevail 
mostly during the hot months — these are Yellow Fever, Cholera In- 
fantum, and the like, while Typhoid and Bilious diseases are frequent 
in autumn, the latter also attributable to the same causes. The quan- 
tity of these offensive vegetable and animal materials is, therefore, among 
other things, supposed to be, in a considerable degree, the generator, and 
regulator of the intensity, of these diseases. But this is not by any 
means the whole of this subject. By a reference to some of the An- 
nual Mortality Reports, it will be seen that sometimes as great a num- 
ber of deaths occurs during the cold months as during the hot. These 
are mostly of those affections attributable to the influence of cold and 
of increased moisture, principally diseases of the Lungs. To a certain 
degree this view of causes is correct, but in both cases, a well-directed 
inquiry into the condition in which people live, the position and ar- 
rangement of their working and lodging rooms, the character of their 
food, their habits of dress and cleanliness, the well or ill ventilated 


roonui they occupy by day and by night, would, in this city, as it 
hai done in other [daces, develope an amount of ignorance and inat- 
tention to the laws of life which would astound the most credulous, 
and fully account for the great and premature mortality of our 

At all seasons of the year, there is an amount of sickness and death in 
this, as in all large cities, far beyond those of less densely peopled, more 
airy and open places, such as country residences. Even in villages 
of small size, there is an observable difference over the isolated country 
dwelling, in the proportionate amount of disease prevailing ; proving 
conclusively that the congregation of animal and vegetable matters, 
with their constant effluvia, which has less chance of escape from the 
/ premises, in proportion to the absence of free circulation of air, is det- 
rimental to the health of the inhabitants. 

These circumstances have never yet been investigated in this city, 
as they should be. Our people, especially the more destitute, have 
been allowed to lire out their brief lives in tainted and unwholesome 
atmospheres, and be subject to the silent and invisible encroachments 
of destructive agencies from every direction, without one warning voice 
being raised to point to them their danger, and without an effort to 
rescue them from their impending fate. Fathers are taken from their 
children, husbands from their wives, " ere they have lived out half 
their days," — ^the widows and orphans are thrown upon public or pri- 
vate charity for support, and the money which is expended to save 
them from starvation, to educate them in the public schools, or, per- 
chance, to maintain them in the work-house or the prison, if judi- 
^ciously spent in improving the sanitary arrangements of the city, and 
instilling into the population a knowledge of the means by which their 
health might be protected, and their lives prolonged and made happy, 
would have been not only saved, but returned to the treasury in the 
increased health of the population, a much better state of public mor- 
als, and, by consequence, a more easily governed and respectable com- 

It is of course among the poorer labouring classes that such know- 
ledge is most wanted. The rich, though they may be equally ignorant 
of the laws of life, and of the best means of its preservation, live in 
larger houses, with freer ventilation, and upon food better adapted to 
/ support health and life. Their means of obtaining greater comforts 
and more luxuries, are to them, though perhaps unconsciously, the very 
reason of their prolonged lives. Besides this, they are less harassed 
by the fears and uncertainty of obtaining for themselves and families 
a sufficiency of food and clothing. They are thus relieved of some of 
the most depressing influences, which tend to reduce the energy of mind 
and body in the poor, and render the latter more susceptible to the in- 
roads of disease. 

Sanitary regulations affect the pauper class of the population more 

/ directly than any other, because they live in situations and circumstances 

which expose them more to attacks of disease. They are more crowded, 

they live more in cellars^ their apartments are less ventilated, and mora 


exposed to vapours and other emanations, &c., hence, ventilation, sew- 
erage, and all other sanitary regulations, are more necessary for them, 
and would produce a greater comparative change in their condition. 
The influence, of drainage.upon the health and lives of the population^ 
is too well known to require, at this day, any argument. Almost every 
one has heard of the effects of marshy soil, in country situations, pro* 
ducing Intermittent Fever^or Fever and Ague, and of the entire disap- 
pearance of the disease, simply by draining off the water, and permit- 
ting the ground to become dry. Its results in populous cities are 
equally well marked. The last instance which has come to my know- 
ledge is one stated by Professor Buckland, that in St. Margaret, Leices- 
ter, England, containing 22,000 inhabitants, it appeared that one portion 
of it was effectually drained, some parts but partially so, and others not 
at all. In the latter, the average duration of life is thirteen yetars and a 
half J while in the same parish, where the drainage is better, thoueh 
only partial, the average is twenty-two years and a halfl showing the 
frightful effects of a ba d atmosphere . It were easy to quote several 
instances, some important ones, from London statistics, but it is unne- 
cessary, as I presume the fact will not be disputed, that sewen^e and 
its kindred measures, exert a striking influence over the condition and 
duration of human life. 

The investigations to which I have briefly alludecl, as so necessarv 
and desirable for this city, have been carried on in other countries, witn 
a degree of enthusiasm, sustained by talent and learning, which does 
honour to Philanthropy. No one can rise from the perusal of the works 
of Edwin Chad wick of London, or of Parent Du Chatelet of Paris, or 
of many others who have laboured in this field of humanity, without 
feeling a portion of the ardor which inspires them, and wishing he had 
been thrown into the same pursuit, that some of the leaves of the same 
laurel might encircle his own brow. It is the cause of Humanity, of 
the poor, the destitute, the degraded, of the virtuous made vicious by the 
force of circumstances, which they are now investigating, and exposing 
to the knowledge of others. 

It is often said that <' one half the world does not know how the 
other half lives." The labor of raising the veil which now separates 
the two halves, by which the misery and degradation of the one, have 
been concealed from the view of the other, has been theirs and their 
associates. Howard, called by distinction the Philanthropist^ reveeXeA 
to the gaze of the astonished multitude the interior of tne prisons of 
England, and straightway the process of reform commenced in them, 
and continued until the prison system of the present day, has become 
one of the most striking examples of the spirit of the times. But Chad- 
wick and Du Chatelet, especially the former, are diving still deeper into 
the subject of moral and physical reform. They are probing to the 
bottom the foul ulcers upon the body of society, and endeavouring to 
discover the causes of so much wretchedness . and vice, which fill the 
prisons and work-houses. Howard's labours tended to cure the disease) 
Chad wick's to prevent it. These operations constitute a highly impor- 
tant part of the great work of melioration and improvement) in the con* 



dition of mankind, now going on, in nearly all civilized countries, and 
which characterize the present age. 

If not on a par, in importance, with the improvement in edacation, 
which has of late made such rapid strides, it certainly is second only to 
it, and indeed it may well be questioned, whether improvement in the 
physical condition of the lower stratum of society, is not a necessary 
precedent, in order that education of the mind may exercise its full and 
proper influence over the general well-being. Teach them how to live, 
so as to avoid diseases and be more comfortable, and then their school 
education will have a redoubled eflect, in mending their morals, and 
rendering them intelligent and happy. But without sound bodies, when 
surrounded with dirt, foul air, and all manner of filthy associations, it is 
vain to expect even the child of education, to be better than his ignorant 
companions, if indeed you do not, by educating him, give him an addi- 
tional weapon, by which he may prey more successfully upon his fellows. 

This country, and especially this city, it is hoped, will not much lon- 

fer be behind others in this cause of the sufi*ering poor and depressed 
umanity. Some movements, promoting this investigation, have re- 
cently been commenced, but much is yet to be done. The path has 
been pointed out to us by pioneers across the Atlantic ; there is abun- 
dant disposition to pursue the object, which only requires to be sought 
out, and put to work by the authorities, to procure all the desirable re- 
sults of such labours. 

Tlie system of tenantage to which large numbers of the poor are sub- 
ject, I think, must be regarded as one of the principal causes, of the 
helpless and noisome manner in which they live. The basis of these 
evils is the subjection of the tenantry, to the merciless inflictions and 
extortions of the suh4ahdlord* A house, or a row, or court of houses, 
is hired by some person of the owner, on a lease of several years, for a 
sum which will yield a feir interest on the cost. The ovmer is thus 
relieved of the great trouble incident to the changes of tenants, and the 
collection of rents. His income is sure from one mdividual, and obtain- 
ed without annoyance or oppression on his part. It then becomes the 
object of the lessee, to make and save as much as possible, with his ad- 
venture, sufficient sometimes to enable him to purchase the property in 
a short time. 

The tenements, in order to admit a greater number of families, are 
divided into small apartments, as numerous as decency will admit. 
Regard to comfort, convenience, and health, is the last motive ; indeed, 
the great ignorance of this class of speculators (who are very frequently 
foreigners and keep a grog shop on the premises) would prevent a pro- 
per observance of these, had they the desire. These closets, for they 
deserve no other name, are then rented to the poor, from week to week, 
or month to month^ the rent being almost invariably required in advance, 
at least for the first few terms. The families moving in first, after the 
house is built, find it clean, but the lessee has no supervision over their 
habits, and however filthy the tenement may become, he cares not, so 
that he receives his rent.' He and his family are often found steeped 
as low in depravity and discomforts, as any of his tenants, being above 



them only in the possession of money, and doubtless often beneath them 
in moral worth and sensibility> 

It is very frequently the case that families, after occupying rooms a 
few weeks, will change their location, leaving behind them all the dirt ' 
which their residence has occasioned. Upon this the next comers will j 
sit down, being so much occupied with the hurry of moving, and with 
the necessity of placing their furniture immediately in order, that atten- 
tion to cleansing the apartment is out of the question, until they are 
^^ settled," and then, if done at all, it is in the most careless and ineffi- 
cient manner. Very often, perhaps in a majority of the cases in the : 
class of which I now speak, no cleaning other than washing the floor, / 
is ever attempted, and that but seldom. Whitewashing, cleaning of ' 
furniture, of bedding, or persons, in many cases is rtever attempted. 
Some have old pieces of carpet, which are never shaken, (they would 
not bear it,) and are used to hide the filth on the floor. Every corner ! 
of the room, of the cupboards, of the entries and stairways, is piled up 
with dirt. The walls and ceilings, with the plaster broken ofi^ in many 
places, exposing the lath and beams, and leaving openings for the 
escape from wfthin of the effluvia of vermin, dead and alive, are smeared 
with the blood of unmentionable insects, and dirt of all indescribable 
colours. The low rooms are diminished in their areas by the necessary 
encroachments of the roof, or the stairs leading to the rooms above ; and 
behind and under them is a hole, into which the light of day never 
enters, and where a small bed is often pushed in, upon which the luck- 
less and degraded tenants pass their nights, weary and comfortless. 

In these places, the filth is allowed to accumulate to an extent almost 
incredible* Hiring their roonos for short periods only, it is very common ;\ 
to find the poor tenants moving from place to place, every few weeks.;' ^ 
By this practice they avoid the trouble of cleansing their rooms, as they^ 
can leave behind them the dirt which they have made. The same room, 
being occupied in rapid succession, by tenant after tenant, it will easily 
be seen how the walls and windows will become broken, the doors and 
floors become injured, the chimneys filled with soot, the whole premises 
populated thickly with vermin, the stairways, the common passage of 
several families, the receptacle for all things noxious, and whatever of i 
self-respect the family might have had, be crushed under the pressure/ 
of the degrading circumstances by which they are surrounded. | 

Another very important particular in the arrangements of these tene- 
ments must here be noticed. By the mode in which the rooms are 
planned, ventilation is entirely prevented. It would seem as if most of 
these places were built expressly for this purpose. They have one or 
two windows, and a door at one side of the room, but no opening any- 
where else. A draught of air through^ is therefore an utter impossibility. 
The confined position of the dwelling itself, generally, prevents the 
access of the external currents of air, even to the outside, to any con- 
siderable extent. The window sashes, in addition, perhaps are so arran- 
ged, that the upper one (if there are two) cannot be let down, being 
permanently fastened up ; hence the external air, poor as it is, cannot 
visit the upper section of the room, unless by opening the door, by which 


\ . ■"■ 

more, beyond the reach of my pen, must be felt and seen, ere you can ap- 
preciate in its full force the mournful and disgusting condition, in which 
many thousands of the subjects of our government pass their lives. 

" There vapors, with malignant breath 
Rise thick, and scatter midnight death." 

There are two features of a cellar residence which more especially 
render them objectionable ; 1st, the dampness, and 2d, the more incom- 
plete ventilation. In any cellar the impossibility of access for the heat 
of the sun to the parts of the soil adjacent to the floor and walls, and 
the absence of currents of air through the room, keep it much more 
damp than rooms above ground, where the heat and air have freer ac- 
cess. This is emphatically the case with inhabited cellars, inasmuch 
as the inmates are careful to exclude the external air, by closing all the 
avenues of its approach, in order to preserve the temperature high in 
winter and low in summer. The moisture, whose escape is thus pre- 
vented, is in itself a very prolific source of disease, and combined with 
the darkness and impure air of these places, is actually productive of a 
great amount of sickness. Could the sun and air be made to reach them^ 
and were it possible to establish a sufficient ventilation through them, 
much of their noxiousness would be relieved ; but under no circum- 
stances can they be made fit for the residence of living beings ; they are 
properly adapted only as receptacles for the dead. 

In addition to these impediments to the drying of these places, they 
are very often so situated, that the surface water finds its way into them 
at every rain storm. It may be remembered that in the summer of 
1843 all the underground apartments in many sections of the city were 
completely flooded by a deluge of rain. In the eastern part of the city, 
in Delancy, Rivington, Stanton, and many other of the neighbouring 
streets, almost every cellar (and great numbers of them are inhabited) 
were half filled with water. This evil will not recur to so great an 
extent, in the neighborhood alluded to, sewers having been built in 
some of the streets. But in other sections, indeed in every section^ 
where the position of the basement is unaltered, and sewers are not con- 
structed, the nuisance must be suffered at every rain storm. In some 
courts to which I can point, the surface is below the level of the street^ 
and at every rain, the water being unable to run off" into the street, is 
all discharged down into the adjacent areas and cellars, keeping them 
almost constantly wet. It was but a short time ago I met with the 
case of a woman, the wife of a tailor living in a noted court in Walker- 
street, and occupying partly a basement, in which she was compelled 
to pass much of her time. She has lived there six months, four of 
which she has been sick with rheumatism, and on that account, unable 
to work. Otherwise she would be able to earn considerable by assist- 
ing her husband. They have four children depending upon them, and 
are obliged to seek assistance from the public, in consequence of this 
sickness. She attributes her disease to the water in the cellar, which 
runs in, and obliges her to bale out, and wipe up, at every storm. The 
money expended upon them in charity, would have rectified all this 


difficulty, have preserved the health and strength of the family, and 
saved all parties much trouble and suffering. 

Another case is that of a woman with two children — her husband a 
labourer — ^living in a cellar in Lewis-street, two months. Before 
moving to this place, she lived in an upper room in Spring-street, and 
was there always well, but has been sick ever since she went to live in the 

Another applied for medical aid who lives in a cellar, immediately ad" 
joining whichy is the vault of a church-yard^ the moisture from which 
comes through into the apartment^ to such an extent^ as obliged them to 
move the bed away from the wall. 

It is not a difficult matter for the Dispensary Physician, while receiv- 
ing applications for medical aid at the office, to distinguish, in a majo- 
rity of cases, the cellar residents from all others, without asking a ques- 
tion. If the whitened and cadaverous countenance should be an insuffi- 
cient guide, the odor of the person will remove all douht ; a musty 
smell, which a damp cellar only can impart, pervades every article of 
dress, the woolens more particularly, as well as the hair and skin. 

At No. 50 Pike-street is a cellar about ten feet square, and seven feet 
high, having only one very small window, and the old fsashioned, inclin- 
ed cellar door. In this small place, were lately residing two families 
consisting of ten persons^ of all ages. 

Dr. Reid, the ventilator of the new houses of parliament, places the 
quantity of air necessary for the perfect, free, and wholesome respiration 
of each adult person at ten cubic feet per minute.* Others before him 
have estimated it as low as two cubic feet. I coincide with Dr. Reid 
in his statement of the amount necessary for the attainment and pre- 
servation of perfect health ; but the latter estimate is entirely too low. 
If We take the average of thes? two extremes, (six feet,) we shall find 
that the ten persons in the cellar of 50 Pike-street would render its 700 
feet of air, unfit for the support of health, in less than fifteen minutes. 
Now, suppose them to retire and close the door and window at ten 
oVlock at night, what must be the condition of the air of the room,-when 
they rise at five the next morning ^ 

Is it astonishing that the Dispensary is called upon, very frequently, 
to extend its aid to these inmates ? and should there not be some remedy 
for this dreadful state of things ? The whole of these premises, besides 
the cellar, is in a condition unfit for human habitation, and yet crowded 
to a melancholy degree. A sanitary law that would reach this case, and 

♦ " If we look to the fact that less than half a cubic foot of air passes through the 
lungs of an adnlt in a minute, this estimate may at first appear excessive, but if we 
remember, that at each expiration, a quantity of air is emitted, which mingles with 
an additional portion of air largely exceeding its own bulk, and that there are twenty 
such expirations in a minute, while provision is likewise required for the air that 
affects the surface of the body, and for the endless variety of minor effects produced 
by furniture, lighting, heating, refreshments, &c: ; where no peculiar adaptation for 
these purposes have been introduced beyond those usually observed, it will be seen 
that the estimate is by no means immoderate. The real guestum is not, what the con- 
ttitution can bear, but that amount which is conveniently accessible in ordinary 
habitations, and which is essential for the toants of the system.'* — ^Illustrations of the 
Thsory and Praotics of Vsntilation, bt David Boswxll Rkid, M. D. 


be wdl tpnlied, iroold save a large amount of life, health, money, and 
moraili.' The same may be said of hundreds of other places, of "which 
thii is a fair iBiyerage sample. - There are many places still worse. 

An inquiry into the amount of air allowed to children in schools, to 
the inmates of prisons, and to laborers in wotk-4ihops^ will exhibit a 
degree of neslect, or ignorance, in relation to this vitally imjx)rtant sub- 
ject, in individuals haying the training andjuardianship of these classes, 
truly lamentable, as Well as surprising, f^r examples. 

One of the Public InfisLnt Schools of this city, having an average atten* 
dance the year round, of 200 children, was for a long time, and until 
recently, kept- in the basement of a church, the dimensions of whi^ 
were 46 x 30 x 8} feet, equal to 11730 cubic feet. The proximity of 
the adjoining buildings rendered it so dark in a sunny day, it was difficult 
to see to write on a slate a short distance from the windows. A large 
atove warmed the room in winter. These children had about six^ 
cubic feet each, for the six school hours, equal to ten cubic feetper hour, 
when each child should have ten cubic feet per minute. VenHlaHon 
wot wUhmighi of^ until recently, and now in consequence of the position 
and arrangement of the building, it is veiy imperfect. 

The dormitories of the House of Refuge have each an area of less 
than 900 cubic feet. When the door is closed on the inmate, his bed, 
which is about eishtee^ inches from the floor, is extended nearly across 
the cell, diminishing by so much its atmospheric, area, and interceptihg 
almost wholly the communication between a very small opening at the 
bottom, and another at the top, and one in the middle, of the door. 
Those openings were intended, but are wholly inadequate, for ventilation, 
even if no bed were there. For the perfect decarbonization of the blood, 
the air in each dormitory, at the lowest proper estimate, will remain suffi- 
ciently pure for the space of thirty minutes only, yet the youthful in- 
mates are locked in from 8' P. M. till 5 A. M. nine hoursy with no other 
veniilaiion than what I have described. Their work-shops cannot be 
said to be much better supplied with air. The effects of this privation 
are plainly marked upon the countenances, and general physical deve- 
lopement, of the children. 

The general arrangement of the cells in the City Prison is but little 
if any better. Besides the small window near the ceiling on one side, 
air is admitted only through five auger holes in the door on the opposite 
side, and these latter are of no service at night, when the inner door is 

We now naturally come, in the course of this inquiry, to two impor- 
tant questions, preparatory to the suggestion I intend to make, of a re- 
medy for these evils. 
1st. What is the effect of this degraded and filthy manner of life upon 

the health of the individuals, and the duration of their lives ? 
2d. What is its influence upon their morals, their self>respect, and ap- 
preciation of virtue ? 

The answers to these queries must have an important bearing upon 
the moral obligations, the pecuniary expenses, and the order and charac- 
ter of the City Government. If it can be shown that much sickness and 


tnauj premature deaths are results of these resideDces, it will be evident 
that the care of the sick, and the support of the widows and orphans, 
must add greatly to the expenses of the city ; and if it can be proved that 
degraded habits, bad associations, and immoral practises (though the re- 
sults only of circumstances, and not of education) are their consequences, 
it will be equally apparent, there will thus be continued, a class in the 
community more difficult to govern, more disposed to robbery, mobs, 
and other lawless acts, and less accessible to the influences of religious 
and moral instruction. 

With regard to the first question, an argument can hardly be necessa- 
ry. Almost every one can recall to mind, some proof of the effects of 
nauseous odors, of the inhalation of foul air, or of sleeping in a small 
confined apartment, upon his own health and feelings. These effects 
may have been only temporary, but they will serve to show that a pro- 
longed continuance of them, must, in reason, produce permanently bad 
results upon the mental and corporeal powers. If the inhaled air (one 
great source of the life, health, and vigor of the animal structure) is 
deteriorated in quality, or diminished in quantity, below the standards 
necessary for a perfect decarbonization of the blood in the lungs, the 
blood necessarily becomes burdened with impurities, and fails to impart 
to the system the qualities demanded by nature for the due maintenance 
of health and strength. Every city resident who takes a stroll into the 
country, can testify to the difference between the atmospheres of the 
two situations ; — the contrast of our out-door (to say nothing of the 
in-door) atmosphere, loaded with the animal and vegetable exhalations 
of our streets, yards, sinks, and cellars — and the air of the mountains, 
rivers, and grassy plains, needs no epicurean lungs to detect it. The 
superior corporeal activity, and the mental exhilaration imparted by it, 
are the prima facie proofs of its superiority. Compare the pale face of 
the city belle, or matron, after the long confinement of the winter and 
spring, with the same countenance in the fall, upon her return from a 
few weeks tour to the Springs and Niagara, and observe whether 
the return of the long absent rose upon the cheek, is not accompanied 
with a greater elasticity of frame, and a happier and stronger tone of 

Descend a few steps further, from the airy and well-lighted chamber 
and parlor, to the confined apartments of the pent-up court, and the 
damp, secluded cellar ; draw a contrast between the gay inhabitant of 
the former, and the attenuated tenant of the latter, and we may then 
judge of the influences of the air, which they respectively respire. 

Observe, further, the vast difference in the development of frame, 
healthiness of countenance, and power of endurance, between the chil- 
dren of the farmer, and the offspring of the city resident. 

A highly respected friend, a distinguished advocate, informed me, 
lately, that some of his children had not had a day's illness during the 
two years they had been iat school in the country, while the others, re- 
siding at home, though in a comparatively salubrious position in the city, 
cost him from twenty to thirty dollars each, per annum, for medicine 
and medical attendance. 


Tke following &cts show, by figures, the sad condition in which a 
very large number of our people may be said, barely to exist. 

As a great part of the population of these places are destitute of the 
means of paying for medical assistance, the duty of ministering to them 
in hours of sickness, falls upon the Dispensary Physicians. I find, 
upon examining the records of their labors, the reports of the three 
medical charities, for the year ending March, 1844, there were pre- 
scribed for at the offices, and the homes of the poor, at the 

Northern Dispensary, 13,317 Patients, 

Eastern « 17,107 « 

New York " 23,868 " 

Total, 54,282 
From this number a deduction is to be made of those vaccinated, being 
4505. In visiting the sick poor at their homes, however, it happens 
very frequently that some are prescribed for, whose names are ne- 
glected to be entered, so that it is perfectly safe to estimate the number 
of sick persons who received aid from these charities, to be over 50,000 
iii one year. In the corresponding year there were admitted into the 
Alms House Hospital 2332 patients, and into the City Hospital, about 
1000, exclusive of seamen, making a total of over 53,000, without 
enumerating the sick poor attended by private charity. 

This is truly an appalling statement. Those unacquainted with the 
number and character of the poor, would scarcely believe so great a 
number actually existed in this city, destitute of means, ana there 
might arise an inclination to suspect an exaggeration of the statements, 
w^ere not the names and residences entered at length on the registers. 

Does it not become the duty of the magistrate and the philanthropist 
upon the presentation of such a statement as this, of the waste and 
havoc of the life, health, and strength of the people, to institute an in- 
quiry into the causes of so great an amount of sickness, and to use 
every possible means to alleviate them ? 

Another fact developed by these reports is conclusive as to the influ- 
ence of the causes to which I have alluded, of this great amount of 

If the habitation of damp, dark cellars, and of n^ow alleys and 
courts, and the breathing of a vitiated atmosphere, are rightly asserted 
to be promotive of disease, then those most subject to these causes 
should be sick in the greatest numbers. Now the male part of this 
class breathe a totally different air through the day, at their labors in 
the streets, along the rivers, or upon buildings, and only at night are 
they subject to the worse atmosphere. Thus more than half their 
hours are passed under more healthful circumstances. Even the boys 
who spend several hours at play, or even in a partially ventilated 
school-house, follow an improved regimen in this particular. On the 
other hand, the females ^ both night and day^ inhale the polluted atmos- 
phere of the dwellings, and are more continually under all the other 
bad influences of their unfortunate situations. 

Do the official results correspond with these premises } 


It will be seen upon examining the Dispensary returns, that in some 
years the proportion of females to males, prescnbed for at the Dispen- 
saries, has been as 12 to lOi — in others, 12 to 8^, and in one in- 
stance as 19 to 11. This comparison is rendered more striking when 
we take into account the greater amount of intemperance among the 

The Annual Reports of the City Inspector show that nearly one-half 
the deaths by consumption are of the foreign part of the populationy 
and that more than one-third the whole number of deaths are of foreign- 
ers. Such an immense disproportion can only be accounted for on 
the supposition that some extraordinary causes of death prevail among 
the strangers who come to reside among us. Now it is a pretty well 
ascertained fact, that a large majority of the cellar and court popula- 
tion of this city consists of persons of foreign birth and their children. 
Of the Dispensary patients, about 60 per cent* are natives of other 
countries, and if it were possible to ascertain the parentage of the chil- 
dren receiving aid from these institutions, we should find a larger pro- 
portion than this directly dependent upon foreigners. There is no doubt 
that 75 percent, of them are either immigrants, or the children of such. 
Put these facts, then, side by side, and we are confirmed in the con- 
clusion that the domiciliary condition of these poor beings, the confined 
spaces in which they dwell, the unwholesome air they breathe, and 
their filth and degradation, are prolific sources of an immense amount 
of distress and sickness, which in their turn, serve, by the loss of time, 
of wages, and of strength, to aggravate the miserableness of their con- 
dition, to increase the danger to the public health, and the burden of 
public and private charity. 

The evils thus resulting are occasionally exhibited in an endemic 
form, i. e., some disease of a marked character will break out and 
attack a considerable number of persons in the same neighborhood, the 
extent of its prevalence depending upon the extent of the cause, or the 
facilities for its propagation. Thus a fever may commence in a certain 
place inhabited mostly by the destitute and filthy : — if the adjoining 
tenements are occupied by the same class of persons, and kept in the 
same dirty and ill-ventilated condition, the tenants of the latter will be 
very liable to attacks of the same disorder. The disease will often be 
observed to pass by houses in a better condition, and re-appear at a 
distance, where similar causes prevail. 

Frequetltly, too, the prevailing disorder, though perhaps covering a 
large district, will be seen only in certain parts of nouses, as the cellars. 
Several instances of this have occurred in New York, one of which 
was the memorable Banker (now Madison) Street fever of 1820. 562 
blacks inhabited the infected district, of wnom 119 lived in cellars; of 
these 119, 54 were sick of the prevailing fever, and 24 died. Of the 
remaining 443, who lived above ground, 101 were sick, and 46 died. 
Out of 48 blacks in 10 cellars, 33 were sick, of whom 14 died, while 
out of 120 whites, living immediately over their heads, in the same 
houses, not one even had the fever. Numerous other instances have 
occurred, which have attracted leas attention, probaUy becaose of their 


fireqaencY rendering them less notorious. But there is, as is well known 
to the pnysicians who move among the»e haunts of wretchedness, a 
silent agency continually at work, destroying annually the health and hires 
of hundreds of our fellow-citizens, and entirely within the power of the 
city government to control or subdue, but which, by a strange neglect, 
appears to have been hitherto allowed to work out destruction Unopposed. 

I am enabled, by the kindness of some of my medical friends, to pre- 
sent a history of some of the endemic diseases which prevail in the 
precincts to which I have alluded. The following communications con- 
tain the testimony of gentlemen thoroughly acquainted with the char- 
acter of these places, and the condition of their inmates, and whose 
opinions are entitled to the most weighty consideration. 

I will only add to their views, that disorders arising and fostered in 
these low places, will sometimes become so virulent as to extend among 
and jeopard the lives of better classes of citizens ; while on the occur- 
rence of general epidemics, these localities constitute minor streams, 
whose poisonous waters, as they mingle with the great river of disease, 
give additional impetus to its destructive current. 

JFVom John A Sufttt, AT D. one of the Attending Phynciam of the City Hoepital, 

New York, August 12th, 1844. 

Dear Doctor. — ^The epidemic continued fever, about which we had 
some conversation a few days ago, occurred during the summer and 
autumn of 1837, at the time I was physician to the N. Y. Dispensary, 
and hadcharee of a district, embracing a part of the 6th, 10th, and 14th 
wards, being hounded on the north and south by Walker and Chatham- 
streets, and extending east and west, from Allen to Mott-streets. The 
first cases occurred, 1 think, in July, and the disease continued to prevail 
in the latter part of September, at which time I ceased to observe it, 
being myself attacked with the same disease, which confined me until 
the cold weather in December, at which time the disease had disappear- 
ed in the district. 

The epidemic interesting me very much, the cases were carefully 
observed, and in many instances full notes were taken of their histor)'. 
The number of cases which fell under my observation was probably 
about thirty — it is very possible it exceeded this. They resembled 
each other very much in their history, and the more so, probably, from 
the fiEict that they were subjected to a very simple and uniform treat- 
ment. The organs principally affected were the brain, and those of the 
abdomen. Delirium and stupor, with tympanitis, and abdominal tender- 
ness, were very commonly noticed, and often in a very marked degree, 
although vomiting and diarrhoea were seldom urgent, and always easily 
controlled. The tongue always became dry as the disease advanced, 
and typhoid symptoms, although not in an aggravated form, usually ap- 
peared before the termination. I remember the frequent occurrence of 
rose colored spots over the abdomen, and that in some instances, they 
were so large and numerous as to constitute one of the most marked 
symptoms, resembling rather the eruption of roseola, than the trifling 


eruption we frequently notice in fever. Nearly all the cases recovered^ 
1 do not remember more than one or two that terminated fatally, and 
in these no post mortem examination was allowed. The treatmenl pur-* 
sued was very simple, and consisted chiefly in attention to cleanliness, 
and to ventilation ; the patients being allowed the free use of simple 
beverage, with the occasional administration of mild purgatives in some 
instances, and small doses of morphine in others ; indeed fresh air, as 
far as it could be had, and cold water, were the principal agents ta 
which I trusted for the restoration of my patients, and I had seldom 
reason to regret my reliance on this simple means. The benefit of this 
mode of treating these cases appeared to me particalarly marked during 
the convalescence, which was surprisingly rapid, and almost invariably 
commenced on or near the fourteenth day after the attack. 

The poor population of this district Was principally Irish and German, 
whose habits, as you know, are more or less filthy, and who lived crowd- 
ed together, with a family in every room in the house, and sometimes 
more. I did not observe, however, that the.disease was decidedly more 
prevalent in those parts of the district which were most filthy and 
crowded, at least so far as individual houses were concerned, although 
if the district be divided into two equal parts by the Bowery, it is a re- 
markable fact that all the cases^ 1 think without an exception, occurred 
to the west of this great thoroughfare, and it is quite certain, also, that 
the poor population is more crowded in this western division where the 
fever prevailed, than in the eastern where it did not exist at all. 

The most striking circumstance that I noticed in this fever was, that 
in every instance (save one which I regard as a doubtful case) the 
disease existed either in basementSy or the first ftoor of houses that had 
neither basements nor cellars under them. This circunostance early attract- 
ed my attention, and constant inquiry never enabled me to find any 
cases in the upper stories of those houses in which the disease was pre- 
vailing in the basement rooms, and yet these upper rooms were as full 
of people and as filthy as those below, and a more or less firequent com- 
munication existed between them. As a matter of course these base- 
ments were less exposed to ventilation than the rooms above, but this 
was not always the case. I remember, in particular, one old wooden 
house at the corner of two streets, without cellar or basement, in which 
the disease prevailed on the ground floor where the ventilation was ex- 
cellent, and where filthy habits were certainly not observed. Indeed, 
it has always been my opinicm that the cause of this fever was an 
emanation from the ground on which the dwellings in which it occur- 
red were standing, and the principal reasons for this opinion I have 
already stated, viz. the abrupt and complete limitation of the disease 
in one direction at least, by the Bowery, and its occurrence only in the 
lowest rooms. I remain truly yours, 

John A. Swett. 

From Stephen Wood, M. D. Physician to the EoMtem JHspenaary. 

211 Madiaon-Btrect, 8tli Mo. 17th, 1844. 

Dear Doctor. — Agreeably to thy request, I have drawn up the fol- 


lowing sketch of some cases, (which have occurred in my practice as 
one of the physicians of the E. Dispensary,) illustrating in some mea- 
sure, the influence of locality and mode of life on health and diseases, 
which thou art at liberty to use in such manner as thou may think 

Some time during the Autumn of last year I attended at No. 249 
Stanton-street, Charles Peterson, aged about fortV'-fiye years, of intem- 
perate habits. He had Pneumonia, followed by Typhus symptoms, and 
lived but two or three days after my first visiting him. He had been 
sick for several days previously, and without medical attendance. At 
No. 96 Sheriff-street, and in the immediate neighborhood of this case, 
and at nearly the same time, I had another of like character, of about the 
same age, and of similar habits. This case likewise terminated fatally 
in the course of a few days. 

In one of these cases the pulse was full and strong, so that I thought 
it best to bleed. The bleeding was followed by blisters, &c. ; but it 
soon became necessary to resort to stimulants, and other supporting 
measures. In the other case bleeding was not practised ; but a blister 
was applied to the chest, expectorants, stimulants, &c., administered, 
although with but temporary relief. 

Both of these men, with their families, were wretchedly poor, living 
in cellar rooms, some six feet below the street, dark and damp, with 
very scanty ventilation, and ceilings, or rather beams so low, that 1 
could not stand erect between them. The apartments at my first visit 
were filthy and oflensivein the extreme ; yet some improvement became 
evident afterwards, as I generally in this class of patients, find it neces-' 
sary in the first place, to lecture them on the importance of cleanhness, 
ventilation, temperance, &c. 

I attribute the result of these cases, mainly to the situation, manner 
of living, and habits of the subjects. This at least was the conclusion I 
recollect I came to at the time ; my attention having being arrested at the 
fatality of cases which at first appeared likely to have a successful issue, 
as I had often had others of a like nature, terminate well under more 
favorable circumstances. 

The vjridow of the patient, at 96 Sheriff-street, died last spring, with 
fever of a low form in the same miserable house. Subsequently at this 
house a quantity of water was found under the flooring. Lodgers were 
taken in there, and on one occasion, I found the owner, a colored 
woman, intoxicated. 

Since her death, between one and two months ago, I attended a man 
of similar habits with the two cases above described, in an upper room 
of the same house with the two last, small, dirty, and badly ventilated. 
This also was a case of Pneumonia Typhoides, and ended in death. 

I have had other cases in these premises at different times, and some 
of them have been attended, (indeed I may say most^) with symptoms 
indicating a low state of the vital forces, and they have been generally 
slow in convalescing. 

All these cases occurred in colored persons. The building in which 
they were is only occupied by persons of this class ; and most of them 


appear to be intemperate, and of the very loweit grade — ^^ the ofiscour- 
ing of all things." 

On the premises, and in the vicinity, are a number of vile grog-shops, 
at which these poor creatures obtain the means of their physical suffer- 
ings, and intellectual, moral, and religious degradation, and too often, it is 
to be feared, their final and lasting ruin. 

1 rejoice however in stating, that within a few months a visible im- 
provement has taken place in these abodes of misery, and in some of 
their occupants. This has been effected mainly by the Health Warden 
and Street Inspecter of the ward (eleventh.) One of the grogeries 
through theii interference has been shut up, some of the worst of the 
rooms closed, and the inmates sent to Blackwell's Island. 

In the course of my practice, I have had many forms of disease ap- 
parently caused and kept up by residence in low, dark, damp, and 
insufficiently Ventilated apartments. Yet I would not exclude the in- 
fluence of other sources of the '* ills which flesh is heir to," particu- 
larly 6( deficient or improper nourishment and bad nursing ; and fre- 
quently no nursing at all, especially among Dispensary patients. 

The condition of the dwellings of many of the poor of our city, is a 
subject much needing the careful attention of the philanthropist, if not 
of our municipal authorities, who, it appears to me, ought to have a 
more watchful supervision of the tenements of this portion of our popu- 
lation. RespectfuUy thy Friend, 

Stephen Wood. 

From B. W. McCready, M. D. late Phyiieian to ih§ City JHgmuary, and City Priaon, 

Wednesday, September 3d, 1844. 

Mr DEAR Sir — If I apprehend aright the purport of your queries, you 
wish to know of me whether I have met with any cases of infectious 
diseases occurring among the poor, which might have been prevented 
by proper sanitary regulations. In the summer of '42, a number of 
cases of Typhus fever, of a very severe type, occurred in a building in 
the rear of No. 49 Elizabeth street, ui^der circumstances which left 
no doubt as to its local origin. The front building, a small two story 
frame house, was partly occupied by the proprietor, or lessee, of the 
building, as a liquor store, and partly sub-let to several Irish &milies. 
A covered alley-way led to the rear building. This was a double frame 
house, three stories in height. It stood in the centre of the yard. Ranged 
next the fence, where a number of pig styes and stables, which sur- 
rounded the yard on three sides. From the quantity of filth, liquid 
and otherwise, thus caused, the ground, 1 suppose, had been rendered 
almost impassable, and to remedy this, the yard had been completely 
boarded over, so that the earth could nowhere be seen. These boards 
were partially decayed, and by a little pressure, even in dry weather, a 
thick greenish fluid could be forced up through their crevices. The 
central building was inhabited wholly by ne^oes. In this building 
there occurred, in the course of six weeks, nine cases of Typhus fever. 
The two first taken^ resided on the ground floor, and both died. The 


othera residing on the second and third floors, finally recovered.. Two 
other cases at least, occorred among those who were temporarily in the 
house as nurses, or visitors, but as they were all at their own houses, 
these patients did not come under my own observation. The disease 
would undoubtedly have spread farther, but the inhabitants took the 
alarm, and the house for a time was deserted. At my solicitation the 
Alderman of the ward visited the building, the number of pigs about the 
establishment was reduced to that allowed by law, and chloride of lime, 
white-washing, &c., liberally, and assiduously employed. 

I had three cases of Typhus in a back cellar, in the rear, I think, of 
16 Marion Street, though it may have been 12 or 14. The cellar was 
ten or twelve feet under ground, the first floor of the house being ^ lit- 
tle elevated above the level of the yard, and dimly lighted (not venti- 
lated) by one small window. It either had no communication what- 
ever with the front cellar, or the communication was completely 
blocked up. A child was in the first place seized by the disease, then 
its mother, then a lodger who lived with them. They all recovered, 
but how, it would be hard to tell. No one appeared to come near 
them, save the visitor from the almshouse, and myself. 

That Typhus fever, generated in the first place under particular cir- 
cumstances, may become highly contagious, is now, I believe, the 
general opinion of the best imormed of the profession. A very strik- 
ing illustration of this occurred in my practice. A young Irish woman 
who had come to this country with her husband and child, was 
taken with Typhus at the house -of her father, just after she had been 
landed from an emigrant ship. The family, at that time, resided in 
Madison Street. She had a very severe attack, and came near dying. 
Next, her father, who had been many years in this country, was seized. 
Then the child. The fiunily now removed from Madison Street to 
Elizabeth Street. The greatest care was taken to preserve proper 
ventilation, cleanliness, &c. In despite of this, the disease sucessively 
attacked two younger brothers, the mother, two grown sisters, and an 
elder brother. I was in attendance in the family from Christmas, at 
which time I found the young woman who was first attacked, almost 
in articulo mortis, till May, when the disease, after having successively 
visited every member of the family, finally disappeared. 

Yours, sincerely, 

B. W. McCready. 

Among the diseases most frequently resulting from an imperfection 
in the means of life, is scrofula^ in its Protean forms. Dr. Watson, of 
London, the latest authority in the Practice of Medicine, in speaking of 
the general causes of this disease, enumerates as the most prominent, 
'* Insufficient nutriment, exposure to wet and cold, impurity of atmos- 
phere, want of natural exercise, and mental disquietude. To estimate 
the separate efiect of each of these causes, may be difficult, but their 
combined influence is unquestionable." After a considerable expe- 
rience in Dispensary and Hospital practice, I hesitate not to declare, 
and believe 1 shall be supported in the opinion by my colleagues in 


the institutioDfi with which I have heen and am now connected, that 
this diseiue is the great scourge of the pauper population. It exhibits 
itself in the skin, in the eyes, the viscera of the abdomen and of the 
chest, in the muscles, and in the bones ; in fact, every organ of the body, 
which is dependent for its healthy condition upon a sound state of the 
blood, (and there is no exception,) may and does give evidence, differ- 
ing in each case, of the influence of this degeneration, and the great 
prevalence of its producing causes. 

The question will very naturally arise in the reader's mind, whether 
much of the ills to which the poor are heir, is not produced by the ne- 
cessarily restricted quantity, and impure quality, of their food. To this 
I reply, that food in the varied imperfections of quality and amount, un- 
questionably constitutes one of the most frequent and powerful of the 
causes of human diseases generally. It is under some of the circum- 
stances of animal organization, no less important to the maintenance of 
life and sound health, than air, with, however, this great and essential 
difference, viz. that an individual may exist several days without any 
additional food, but not three minutes without air. Further, if he is 
deprived of but one of the ingredients of the atmosphere, oxygen, in- 
stant death is the consequence. 

I believe, however, it will be found, in a vast majority of cases, 
where food is properly accounted a cause of illness, this is produced by 
-too great a quantity being eaten^ or by an alteration of its properties by 
the refinements of cookery, and the addition of stimulating condiments. 
Plethora, and its long train of ills, are the results of over feeding, and 
over stimulation, but these are not the diseases of the poor. Among 
them we rather find. Cachexia,* Scrofula, and all the consequences of 
debility and vitiation, which are far more attributable to an imperfec- 
tion and paucity in the necessaries of life, more especially of air, cloth- 
ing, and cleanliness. Dyspepsia, almost wholly the effect of improper 
dieting, is scarcely ever found in Dispensary practice, while no disease 
is more common with the wealthier classes. All the ills for which the 
poor seek advice, whether peculiar to them or not, are aggravated, and 
altered in character, not by the food they eat, so much as by the air 
they breathe, and their other depraved physical circumstances of life. 
The sin of intemperance in eating cannot be laid at the doors of the 
cellars, and the entrances of the alleys and courts, while that of intem- 
perance in drinking, though a dreadful addition to the horrors of his 
already too degraded physical and moral condition, is, with the ignorant 
and poverty-stricken troglodyte, a venial fault, in comparison with 
the pampered luxuriousness and equally injurious and intemperate, 
though more refined indulgences of his wealthier and more respon- 
sible neighbor. 

I conclude this part of my subject, by calling attention to a few 
facts, illustrating the relative duration of life, of different classes of 
population ; premising that, in consequence of the imperfection of our 
means in obtaining the statistics of vitality and mortality of our own 

« A bad habit of body, known by a dei»raved or vitiated state of the solids and fluids. 


population, it will be necessary to go abroad for some of the facta which 
bear upon this important inquiry. 

It is ascertained that in civilized communities, one-fourth part of all 
the human race who are born, die before attaining their first year ; 
more than one-third before arriving at five years of age, and before the 
age of twenty, one half the human race, it is supposed, cease ta exist. 
On referring to the last two annual reports of the mortality of this 
city, I observe that of the persons who have cUedj about the same pro- 
portion as is above stated, of all who are borrij that is, about one- 
fourth died in the first year, about one-third before five years, but more 
than one half before twenty years of age. 

No facts could speak in louder tones of the injurious operations of 
the circumstances of civilized life. That one-half should die before 
arriving fairly upon the broad platform of strength, usefulness, and hope 
in the world, is the significant finger pointing with unerring certainty 
to the sins of ignorance, and abuse of the bountifiil and unfailing means 
of life and comfort lavished upon us by Providence, which lie at our 
doors. Can this ignorance of the laws of health be excused, or can 
this abuse of Heaven's bounties be defended ? There can be no justifi- 
cation for either in the eye of the Creator and Giver of all things. 

The savages who live in the caves of the earth, because they have nei- 
ther thfe knowledge, nor means, to build houses^ are pardonable ; yet their 
natural instincts teach them the uses and necessity of fresh air and exer- 
cise. Yet we, who claim to be intelligent and civilized, who are taught 
the minutest particulars of nature's laws, suffer our numbers and strength, 
the bones, and sinews, and hearts of our people, to waste and die away 
in narrow and gloomy caverns of our own construction, with a rapidity 
surpassing that of the combined torrents of pestilence and war. Our 
sin is the greater that we permit these things in the midst of the light 
of science, and under the inspiring dictates of a religion, whose most 
prominent features are charity and love. 

In the celebrated report of the Sanitary Condition of the Laboring 
Population of Great Britain, Mr. Chadwick gives the following, among 
other instances, of the comparative chances of life, in different classes 
of the community. 


No. of Deaths. Aver, age of Dec'd. 

33 Professional persons, or gentry and their families, 40 years. 

138 Persons engaged in trade, or similarly circumstanced, and 

their families, 33 " 

447 Laborers, Artisans, and their families, 28 " 

Bolton Union (manufacturing district.) 

103 Gentlemen, professional persons, and their families, 
3S1 Tradesmen, and their families, 
2232 Mechanics, servants, laborers, and their families, 

Beihnal Green (manufacturing, chiefly domestic.) 

101 Gentlemen, and persons engaged in Professions, and 

their families, 45 " 

273 Tradesmen and their families, 26 

1258 Mechanics, servants, laborers, and their families, 16 








In Liverpool, a commercial, and not a manu&cturing town, where^ 
according to the report of Dr. Duncan, 40,000 p^ple live in cellars, 
and where one in twenty-five of the population are annually attacked 
with fever, the mean chances of life appear to be still lower, than in 
Manchester, Leeds, or among the silk weavers of Bethnal Green. In 
size and character Liverpool is somewhat allied to New Yoik, hence 
its^vital statistics are more particularly interesting to us, as more likely 
to approach ours in similarity. 

Liverpool, 1840. 

No. of Deathi. Arer. ag t of Dec*d. 
137 Gentry, Professional persons, &c. 35 yean. 

1738 Tradesmen, and their famiKes, 22 

5597 Laborers, Mechanics, Servants, dec. 15 


The following shows the difference in the average duration of life, 
between the inhabitants of a manufacturing and of an agricultural place, 
and it will be observed that the laborers of tike loiter^ attain to an Ofe 
equal to the professional peopkj and gentry j of the former. 

Average age of Death 
in Maochoiter, in Rutlandahire. 

Professional persons, and gentry and their families, 38 years. 52 years. 

Tradesmen and their families, (Farmers and Graziers 

included with Shopkeepers, in Rutlandshire,) 20 " 41 " 

Mechanics, laborers and their families, 17 " 38 " 

This comparison exhibits very clearly the advantages of a pure atmo- 
sphere, out-door occupation, domiciliary cleanliness, and above ground 
residence, Rutlandshire being distinguisl^ed for all these, and as a conse- 
quence, for a more orderly, steady^ and respectable population. 

The influence of degraded associations, of habitual neglect of cleanli- 
ness, and prostration ot health by impure living, upon the moral habits 
' of the people, and as impediments to their social and political improve- 
ment, is a question with which 1 propose now to occupy the reader's 
jfcttention, for a brief space, in the hope, that if it can be shown that 
fthese are probable causes of misery and crime, there will be found herein 
ran additional reason for the action of the City government upon the 
tneasures, I, or others may suggest, for the melioration of the condition 
fOf those classes of the community more exposed to their influences. 

Let any one ask himself the question, whether his own self-respect, 
;his carefulness to avoid improprieties of conduct, and to maintain clean- 
iliness of house and person, are not greatly enhanced by the examples of 
Tthose around him. I believe it will not be disputed that the practices of 
dhose with whom we associate, by choice or compulsion, possess a decid- 
ed influence over not only our own acts and habits, but over our thoughts 
•jmd even our judgments. Circumstances govern our lives, and precepts 
ifor good are feeble, unless accompanied by the strong arm of example. 
^<' Example is better than precept," was the lesson taught us daily in 
«our school exercises id penmanship. All society regulates the conduct 
4of its members, and its phases of character are marked by their deport- 


ment and opinions. The '* outcasts of society " constituting a very 
numerous tribe, form societies of their own, and stamp, in a degree, the 
character of the community of which they are a part. We nave, as 
have all large cities, numbers of them with us, but they should be re- 
garded, not as such by choice, so much as by compubiwi — as the crea- 
tures of circumstances beyond their control. 

The tide of emigration which now sets so strongly towards our shores, 
cannot be turned back. We must receive the poor, the ignorant, and 
the opfNressed from other lands, and it would be better to consider them 
as coming filled with the energy of hope for happier days, and more 
useful labors, than they found at home. No one, I presume, seriously 
believes they come with bad intentions, and then whose fault is it that 
they live here in cellars more filthy than the cabins pf whose wretch- 
edness we hear so much, and for whose existence, half the blame is 
thrown upon the government they have left. 

Let us first cast the beam from our own eye. We are parties to their 
degradation^ inasmuch as tee permit the inhabitation of places ^ from which 
it is not possible improvement in condition or habits can come. We suffer 
the sub-landlord to stow them, like cattle, in pens^ and to compel them 
to swallow poison with every breath. They are allowed^ may it 
not be said required^ to live in dirt, when the reverse, rather, should be 

This depressed physical condition, and bad moral and social habits 
and propensities, to my mind, have an intimate relation to each other — 
they stand clearly in the attitudes of cause and efifect For instance, 
how often do we find poverty to be the instigator of theft, and immoral 
indulgences the results of certain circumstances in life. 

Men's passions are kept in check by the restrictions of the society 
in which they live. Remove those checks — take from the individuals 
the moral atmosphere in which they move, and their evil passions 
will rise. 

In a family composed of several persons of both sexes, in circum- 
stances admitting of their living in separate apartments, the restraints 
of the circle of which they are a part, compel an observance of the 
separation ot the sexes, and other social proprieties. They grow up 
habituated to correct deportment and moral restraints, which accompany 
them into all their relations of life. But confine that same family to 
one room, compel them to perform all their personal and domestic duties 
in view of each other, to sleep, dress, and undress in each other's pre- 
sence, and can it be doubted that the nice moral distinctions so neces- 
sary to a life of virtue, will be gradually subdued, or overthrown, the 
heart be hardened against the teachings of the moralist, and the wave 
of lustful passion become of increased power ? Yet this is the condi- 
tion of hundreds of families, who would gladly escape the Maelstrom 
of morals which threatens to engulf them. And this is undoubtedly 
a principal source of the dreadful amount of licentiousness infesting 
this city. 

As breathing an impure atmosphere will produce a depressed tone of 
bodily feeling and positive physical disease, so will a vitiated moral at- 


mosphere, induce a relaxed state of moral feeling, and positively liceu-' 
tious habits. 

Whence issue, in times of riot and tumult, the disturbers of the 
peace, but firom the cellars and alleys, where they have never been 
taught to respect themselves, much less others. 

If a family of good disposition be reduced by force of circumstances 
to occupy the same premises with numbers of others of a different char- 
acter, it will be next to impossible to maintain their former tone of 
morals, or domiciliary cleanliness and order, and they must soon lapse 
into the same habits and feelings as their neighbors, adding thus their 
numbers to those who before swelled the list of the profane and evil 

I have remarked upon the influence of the impure atmosphere, the 
damp and crowded apartments, and other circumstances, upon the health 
of the poorer residents of New York : — ^the following extract from an 
able writer* must commend itself, in this connection, to the judgment 
of every right thinking man. 

'' Although it is most true that the calamity of sickness, or even of 
death itself, is nothing compared with crime, yet it is also true, that 
sickness induces poverty, which is one of the tempters to crime, and 
that a deranged condition of the physical system, often urges to vicious 
and destructive indulgences by the unnatural appetites which it creates, 
and thus ill health becomes the parent of guilt as well as of bodily 
pains. It exercises a powerful influence over feelings, temper, and dis- 
position, and through these upon moral character." 

It follows, thereU)re, that a correction of the physical, will tend to 
abate the moral, evils of the community. 

It is well known there has existed in this city for a series of years, 
an organization denominated the City Tract Society, which supports a 
number of Tract Missionaries, whose tinie is devoted to visiting the 
abodes of the humble and destitute, wherever the way may open, ahd 
carrying to them the words of moral and religious instruction — endeav- 
oring to instil into their minds ideas of self-respect, and self-dependence, 
preaching to them temperance and virtue, enticing children to the Sal>- 
bath and public schools, relieving with what means they may possess, 
the physical necessities of the poor, and performing all other deeds 
which a mind actuated by benevolence and Christian love may do. 
Many of these gentlemen have been a long time engaged in this work, 
and probably no body of men possesses more thorough knowledge of 
the localities of this city, of the condition of its inhabitants, of the in- 
fluence of circumstances upon the tone of morals in all classes, drawn 
firom actual observation, or of the alterations and additions required in 
the police and sanitary codes, for the improvement of the city at large^ 
and in its various particulars. 

To these gentlemen I have applied for their opinions, and such illus- 
trations, bearing upon this topic, as their prolonged and valuable expe- 
rience may be supposed to have furnished them. I addressed to them 

* Hon. Horace Mtnm 


the following queries — ^the subjoined responses^ selected from amone a 
number, must carry conviction to the minds of all who tead them^ that 
an effort is demanded of government, benevolence and wealth, to re-* 
move the impediments now lying in the way of the physical and moral 
improvement of the destitute classes of this city. 

Queries addressed to the Tract Missionaries. 

1st. To what extent does the congregation of different sexes, and 
various ages of the same &mily of the poor, in one apartment, influence 
their morals, and do they, or do they not, seem to place a lower estimate 
on moral character, (though free from actual vice,) than others, a grade 
above them in physical condition ? In other words, have you observed 
an appreciation of morals and character, graduated according to the 
circumstances and condition of life ? 

2d. Have you found physical distress to present a bar to your 
moral and religious instructions, and do you think relief from their 
bodily ailments would enable you to be of greater service to the poor 
in your calling ? 

3d. Have you observed that personal and domiciliary negligence and 
fiilthiness tend to depress still more the moral sensibility, and make the 
poor more reckless of character — and do you believe, that domiciliary 
and personal cleanliness, though combined with an equal degree of 
poverty, give to the individual or family, more self-respect, more 
aptitude to receive instruction^ and more happiness ? 

4th. If constrained by law to keep themselves, their furniture, clothing 
and dwellings, more clean, by frequent use of water and lime, do 3'ou 
think there would be a greater inclination to improve their associations^ 
and obtain a better state of moral and social feeling ? 

5th. In your opinion would regular domiciliary visits by an officer of 
health, empowered to enforce a law to promote the cleanliness of house 
and persons, have any influence in raising the tone of feeling among the 
poor, as well as relieving sickness and prolonging life } 

6th. Are there not many who would be pleased to be aided and in- 
structed in the best mode of improving the condition of their dwellings, 
and be glad to receive the visits of such an officer ? 

7th. Can you relate any instances bearing on the subject, or applicable 
as illustrations to either of the queries } 

Fi'om Rev. George Hatt, Missionary of Ist and 2d Wards. 

Answer 1st. It is impossible to state to what extent a bad influence 
is produced by the congregation of different sexes in one apartment, but 
that it tends to debase the mind, and more especially in the female, pre- 
vents the development of that sensitive modesty which is her greatest 
charm, and her surest protection, I think no one can doubt. Still in 
my opinion, it is unfair and incorrect to measure appreciation of charac- 
ter by outward circumstances, or condition of life. The many offices 
to which the one apartment must be converted, produces a want of neat- 
ness, and personal cleanliness. A single fact will show some of the 


evils of the one room syitem. As a Tract visiter knocked at the door 
of a room, he was invited in ; he opened the door and entered, when, 
to his astonishment, he found a man entirely naked, sitting with his vrife 
and children ; the former was washing the shirt whicn the man had 
taken off. This was on a Sabhath day. 

Answer 2d. Physical distress often prevents the poor, or indeed any 
class, from beine benefited by religious instruction. But on the other 
hand, it often softens and prepares the mind for its more ready reception ; 
I believe the possession of the ability, judiciously to relieve the pressing 
wants of the pooi, and to alleviate their bodily ailments, would be ot 
great service in the attempt to elevate their moral and social condition. 

Answer 3d. I should presume that recklessness of character generally 
precedes negligence and filthiness — for instance, I have known a man 
who had a happ}' home to become a diunkard ; this vice soon reduced 
him from an industrious, cleanly man, to a reckless, loathsome being. 
His wife, too, having become discouraged , falls into the snare. Now the 
once happy home is a scene of filth and confusion. Go to work with 
that family, become instrumental in restoring them to sobriety and in- 
dustry, and the change will be as apparent in the second instance as it 
was in the first. 

As it respects the latter part of this question, I would add, that much, 
very much, depends upon the manner in which individuals are brought 
up. . Some families will with six dollars per week, appear more respecta- 
ble, and possess more self-respect than others with ten dollars, with an 
equal number in the family. The difficulty in most cases is in the 
training. Hence the importance of educating the young. 

Answer 4th. In my opinion constraint by law ought to be on the 
landlord. No landlord ought to be allowed to let a place whi6h is 
known to be unhealthy under a heavy penalty. There are thousands 
in this city who are pent up in cellars, with ground for the floor, into 
which I would not put a hog, if I wanted him to thrive. Last winter 
I visited a place in Washington-street, where in one such hole, thirteen 
persons were staying, four adults, and nine children. At times the tide 
came in ; it was slways damp, and there was a woman sick with 

Ansioer 5th. Then in reference to the fifth question, I would say, that 
the health officer should be empowered to levy the fine upon landlords 
who transgressed the law. The officer should be empowered also to 
remove the family into some healthy abode, taking care that the fine be 
enough to cover expenses, and that having done so, the unhealthy place 
should be locked up, and the key kept by the officer, until a guarantee 
be given, that, if possible, the place be rendered habitable. 

Answer 6th. I would recommend that the corporation build, and en- 
courage the building of houses suitable for the poor, so constructed that 
each Htmily may have at least two rooms ; do this, and many of those 
evils which now exist will be done away, and the blessing of many who 
are now ready to perish, will come upon them. 


Frcm /. B, Biortim, MittUmaryi of the Ith Ward. 

New York August 2dd, 1844. 
Dr. Griscom. — Dear Sir — Your questions in relation to the demo- 
ralizing influences resulting from the unhappy physical condiHon g[ a 
multitude of families in this city — both as it regards the numbers of all 
ages and each sev.y jammed hUo one apartmefii'--ihBi with some miserable 
additions to its list of uses reminds us of the poor cobbler's stall in the 
song, which '^ He us'd for kitchen, for parlor, for hall," — and the neg- 
ligence of personal and domiciliary cleanliness ; with others concerning 
the best means of obviating those evils, requesting me to give such an- 
swers to each and all, as my judgment and experience shall dictate, 
with such illustration of facts, as my Missionary labors in this city for 
ten years past may have furnished, are before me, and shall receive due 

For I hail with joy any feasible project, or attempt, to meliorate the 
natural or moral condition of man, and especially of that class of my 
own fellow-citizens, who so far from reposing on beds of roses or down, 
seem doomed to endless toil by day — and by night to lie down, perhaps 
in a crowded, uncleanly, and unventilated apartment, where before their 
slumbers are ended, the air has been so often inhaled, that it would need 
but little further diminution of its vital qualities, to become so foul as to 
cause them '^ to sUepy to wake no more?* And I rejoice, sir, that yoa 
have undertaken the task of presenting to the authorities of this city 
and the public, such views of the physical and moral condition of our 
city, and the appropriate means of improving it in both respects, as will, 
I trust, not only do honor to your head and heart, but lead ultimately 
to such sanitary regulations, as shall make this great emporium of the 
commerce of the Western world, not only as renowned for natural and 
moral purity^ as for the amount of her wealth and the extent of her com- 
mercial enterprise, but as the exuberant goodness of God in bestowing on 
her naturally a pure air, and civilly and artificially the free use of the 
Holy Bible and Croton water, has given her the means to be. 

I now proceed to answer the questions propounded. And first, you 
inquire, '* To what extent does the congregation of different sexes, 
and various ages of the same family of the poor, in one apartment^ influ- 
ence their morals, and do they, or do they not, seem to place a lower 
estimate on moral character, than others placed a grade above them in 
physical condition ?" As it regards the extent of the evil influence on 
morals, arising from such herding together, of all ages and both sexes, 
it is impossible for me to determine, but that it is of most pernicious 
tendency, no one who has the slightest acquaintance with poor human 
nature, can, for a moment, entertain a doubt. Under such circumstances, 
it is impossible from the nature of things to prevent the instinctive mo- 
desty of youth from receiving a mortal wound, by a constant familiarity 
with scenes and sounds fit only for the greatest privacy — " For (truly) 
nature's blush by custom is wiped off!" 

And thus one of the greatest barriers and defences of chastity, is in 
the very morning of life overturned and destroyed ; that jewel of such ines- 
timable value, that the means of its preservation is worthy of the most pro- 



f found consideration of the statesman and philanthropist. That the 

^ physical condition of an individual or a family, has a powerful and import- 

! ant bearing on the moral character, for weal or woe, needs no labor to 

prove ^ although neither of us has any idea of embracing Fonrieiism- 
*^ the main doctrme of which, I believe, is, that most of the ills of life, 
now experienced in the world, flow not from the mwal obliquity of 
human nature, but from the wrong^ cMlj and physical position of men. 
^' Poverty and riches are both severe temptations," the latter, however, 
by far more dangerous, at least to the final and eternal interests of men. 
For though abject poverty may lead to brutal degradation, placing fa- 
milies even in Christian communities in circumstances as unfavorable 
to chastity, and the common decencies of life, as the Sandwich Island- 
ers were previous to the introduction of Christianity among them by 
American Missionaries — when they slept in their one apartment^ men, 
women and children, %mth their hogs^ " cheek by jowl !" Yet riches 
foster appetites and passions still more hostile to virtue and religion ; 
hence it was averred by the Maker and Savior of men, that '' it is ea- 
sier for a camel to go through a needless eye than for a rich man to 
enter the kingdom of Gk)d." Extremes meet — therefore I have made 
some of the foregoing observations, to show that every gradation in 
the circumstances of an individual or a family, from abject poverty to 
"a happy mediocrity j^"* defined exactly in Agur's prayer, "Neither 
poverty nor riches," (which even the insensate infidel Tom Paine, had 
not the moral hardihood to deny as replete with true wisdom,) will have 
a good influence on their morals, but not beyond that point. 

1 have farther to say in relation to this question, that though I have 
not the shadow of a doubt resting on my mind, as to the deteriorating 
moral efi*ect of a large family embracing both sexes and all ages, being 
pent up in one apartment, where a// /Atn^s must be done in commofiy 
yet 1 have no striking facts as an illustration in proof to give, but have 
a distinct impression tl^at where I have met with families so circum- 
stanced, or among the abject poor, their moral sensibilities in some re- 
spects were very obtuse, and in nothing that I recollect more often 
manifested than the shameful nudities of children. 

In regardt o your second question, " Have you found physical distress 
to present a bar to your moral and religious instructions, and do you 
think their relief from bodily ailments would enable you to be of 
greater service to the poor in your calling ?" I answer, that I have of- 
ten found persons and families, in such circumstances of distress, from 
want of food and raiment, or by excruciating bodily pain, I thought 
it would be preposterous and vain to say much to them on the subject 
of religion, until their minds and bodies were somewhat relieved and 
disenthraled from the absorbing power of want and pain by physical ap- 
pliances. And always under such circumstances, I have gone to work 
to procure food and clothing, or a physician and medicine ! to prepare 
the way for moral and religious culture. And happy should 1 be if the 
facility for ministering to the poor and suflering were many fold in- 
creased, as it regards giving the worthy poor both food and physic ; 
thereby increasing our prospect of being useful to them in religious 


matters. And I rejoice in the society recently organized in this city, by 
a truly intelligent and. philanthropic class of our wealthy citizens, for 
'^ the improvement of the condition of the poor," who have already 
prepared the way for the Tract Missionary to exert the happiest influ- 
ence on hundreds of families. 

As proof that physical distress and bodily ailments present a bar to 
moral and religious culture, I have only to assure you, that the com- 
mon answer given to Missionaries by persons in such circumstances, 
when asked if they wish to seek religion, or avail themselves of the 
means of grace by attending church, or of Sabbath and public school 
instruction for their jchildren, ia this, " Oh, w# are so poor — we have 
such trouble to get our daily bread, so destitute of comfortable and de- 
cent apparel, that we have no time to think about religion — cannot go 
decently to church, nor send our children to Sabbath or public schools." 

In answer to your third question, viz. ^^ Have you observed that 
personal and domiciliary negligence and filthiness tend to depress still 
more the moral sensibilities, and make the poor still more reckless of 
character ; and do you believe that domiciliary and personal cleanliness, 
though combined with equal poverty, give the individual or family 
more self-respect, more aptitude to receive instruction, and more hap- 
piness ?" I reply, that I have observed those families and persons 
who live habitually in squalid filth, negligent of personal and domicili- 
ary cleanliness, like wicked men and seducers, wax morally worse and 
wbrse. And were it proper, I should like to introduce you to two 
such families, who are now prominently before my mind, for whom I 
have long labored, but apparently in vain, as it regards their moral re- 
formation, while on the other hand I could introduce you to those who, 
though equally poor, yet careful about their persons and places, have 
received instruction gladly, and as we trust with lasting profit — and 
none can doubt for a moment that the latter class are by far more hap- 
py ; though through a perverted taste, it may be possible for a savage 
" to glory in the deepest jet." 

Your fourth and fifth questions involve so nearly the same thing — a^ 
mere requisition of my opinion, " Whether the interference of municipal 
authority — constraining by law, and law officers — the dirty and negli- 
gent, to take better care of their persons, furniture, and apartments, 
would subserve any valuable purpose, or raise a better tone of moral 
and social feeling ?" — for brevity's sake, I shall consider and answer them 
as one, by saying that I can see no good reason why a State and City 
that have legislated so immensely^ and sacrificed so much public and pri- 
vate property to establish and execute Quarantine Laws, (many of them 
of more than doubtful utility,) to prevent the importation of Yellow 
Fever, Cholera, and the Plague, into our populous city, should by any 
means judge it absurd or unnecessary, to enact a few laws, and appoint 
a few officers to inspect certain persons and places within the city, 
(with power to remove) where and by whom all those infectious and 
contagious maladies may be manufactured, and of such a quality, too, as 
to be perhaps more dangerous than those of foreign growth. 

In regard to your 6th question, " Whether there are not many families 


that would like to be aided and instructed in the best mode of unproving 
the condition of their dwellings, and would be glad to receive the visits 
of such an officer ?" I answer, that the feeling with which such 
an officer would be received, must materially depend on the ability 
and tact with which he would discharge a duty so delicate — for deli- 
cate indeed it must be to interfere with the private concerns of 
any individual, however poor he may be — that claims to be one of 
the independent citizens of the United StcUes — one of the sovereign 
people ! However, I do not believe, though the task should be arduous, 
but that some such regulations might be introduced into our city, with 
the happiest results. lAt I should perfectly despair of the success of 
any such sanitary measures if adopted, should those who have the 
power of appointing the necessary officers, manifest the same reckless 
indifference to their talents and attainments in medical skill and science, 
as we have sometimes heretofore had the misfortune to see manifested 
in the appointment of health officers. 

I have now gone through with your questions, dear sir, and answered 
them according to my best ability, and the limited time allotted me ; but 
not perhaps in a way that will be satisfactory to yourself, or available 
for the public good. You will, however, I have no doubt, in your kind- 
ness, take " the will (in this instance) to serve," for the deed. 

But before I close this already long communication, I beg leave to 
suggest to you one thing to be brought forward in some part of your 
work, viz. to show the far greater propriety and necessity of having an 
Inspector General, with plenty of sub-officers, who shall determine 
where, and what kind of a house shall be built for a human being, or a 
family to inhabit ; and how much room — and how many rooms, shall be 
rented to families consisting of so many persons, and such sexes, than 
an inspector general and his posse, to examine dead beef and pork, flour, 
tobacco, &c., that nobody is forced to buy or use if bad, while the 
poor are literally forced by poverty and griping landlords, to live in dens 
and holes, where immorality and death are speedily engendered. Yet 
still farther and above all^ do, my dear sir, bring out most prominently 
the absolute futility of any sanitary measures, for the health, or morals 
of this city as a whole, until that curse of all curses most direful, that 
most prolific source oi poverty , crimen disea>se, wad death, "Intoxica- 
ting drinky''^ be considered and treated legislatively and judiciously as 
a most dangerous, deleterious, and deadly poison, and those who make 
and sell the «ame as a beverage for gain, as unworthy, not only of the 
name of Christian but of man, and should henceforth be ranked with 
fiends — and those who drink it as such — as maniacs, and fools, and 
treated accordingly. With much respect, yours, 


Drorn Samvd Russell, Jr., Missionary of the 8th Ward. 

New York, Aug. 26th, 1844. 

Dr. Griscom — Dear Sir — Whether the sentiment of the great 
Teacher, " The poor ye have always," is the mere record of an impor- 
tant /ac^ or &predictiony I shall not stop to inquire ; one thing, however, 


is certain, it ever has been, and is now, a sentiment of truth ; and a true 
disciple of that teacher, will rejoice in any efforts of others, and con- 
tribute his own, for the well-being of that large class of the commu- 

Having been engaged for several years in labors for the benefit of the 
poor, the following opinions have been formed, and are submitted in reply 
to your series of questions ; hoping that they may, in some humble 
measure, subserve the best interests of that class whose servant 1 am, 
and hope to be, during the remainder of my life. 

1st. The instances are many, in which one or more families, of from 
three to seven or more members, of all ages, and both sexes, are con- 
gregated in a single, and often contracted apartment. Here they eat, 
drink, sleep, wash, dress and undress, without the possibility of that 
privacy which an innate modesty imperatively demands ; in sickness 
or health it is the same. What is the consequence } The sense of 
shame, that greatest, surest safeguard to virtue, except the grace of God, 
is gradually blunted, ruined, and finally destroyed. Now scenes are 
witnessed and participated in, with a countenance of brass, the very 
thought of which, once would have filled the sensitive heart of modesty 
with pain, and covered its cheek with burning blushes. The mind 
of one thus brought in daily and nightly contact with such scenes, 
must become greatly debased, and its &11 before the assaults of vice 
rendered almost certain. 

In reply to the latter part of the question, allow me to say that neither 
extreme of society is favourable to the highest appreciation of morality. 
The rich man who delights in sinful indulgence, and retains his position 
in society by his gold, places really no higher estimate upon virtue for 
its ovm sakcy than the veriest wretch, who in the eye of day, wallows 
in the very mire of moral pollution. From such a one, to him who 
retains his place among his fellows by his virtues^ there is, doubtless, a 
regular gradation in the appreciation of morals and character. 

2d. Physical distress often introduces me to the acquaintance of fa- 
milies, when if they were in other circumstances, access to them might 
not be obtained ; yet before any moral or spiritual instruction will be 
regarded, the wants and ailments of body must first be cared for. 

Before the formation of the " Society for the' improvement of the 
condition of the poor," my usefulness was greatly curtailed from the 
impossibility of ministering to the ph3'sical wants of the poor ; now it is 
otherwise, thanks to the noble men comprising that society. 

3d. This question, I answer unhesitatingly, in the affirmative. 

4th. The law of kindness in the heart, and the words of sympathy 
upon the lips, afford the surest avenue to the confidence of the poor, 
and will succeed when legal coercion will utterly fail. Use the former 
when you caUj the latter when you must. 

5th. The success or failure of such visitation would depend very 
much, if not entirely, upon the character of the officer, and his man- 
ner of performing such visitation. If possessed of a kind and affable 
manner, and if a desire for the comfort and permanent good of the poor 
were discernible in all his deportment, he would hardly be regarded as 


an officer of l^w, but as a friend to be confided in, and his instrnctiontf 
appreciated and followed — if otherwise, he would be looked upon with 
mistrust, and probably resisted. 

6th. This question I answer in the affirmative, provided the officer 
possess the qualifications named in the reply to the fifth query ; and 
also provided the expense be borne by the landlord, or the public — 
otherwise, in the negative. 

7th. A multiplicity of cases bearing on this whole subject have led 
me to the conclusion to which I have come, and expressed above ; but 
no particular one now occurs to my mind, of sufficient interest, to war* 
rant being repeated here. 

The published reports of the " City Tract Society," in numerous 
instances, show what means have resulted in the elevation of the poofy 
and to those documents I would beg leave respectfully to refer you. 

Yo^rs, &c. Samuel Russell, Jr. 

Missionary, 8th Ward. 

From Jno. H. JBukn, Miuionary of the 13th Ward. 

New York, August 20th, 1844. 

Dear Sir — The subject of your recent note, making certain inqui-^ 
ries, is one of no ordinary interest to any one who is endeavoring, in a 
sphere however circumscribed, or by means however humble, to be in- 
strumental in elevating the moral condition of man. 

The intimate relation of the moral to the physical condition, may 
not be so easily and precisely defined, as practically understood ; and per- 
haps your end will be as fully attained by eliciting the results of expe- 
rience, as by any fine wrought, philosophical disquisition of that rela- 
tion. I am truly glad you have taken the subject in hand. I have 
long wished that some one, able to make his voice heard by the com- 
munity, would speak out in language to be understood. Should you 
succeed in awakening an interest in the community, which shall result 
in the domiciliary renovation at which you aim, you will need no re- 
ward but the rich consciousness of having rendered valuable aid to the 
philanthropic enterprises of the day. 

Nearly ten years' constant intercourse with the poor of this city, has 
fully convinced me that no greater obstacle is presented to their moral 
elevation, than that want of self-respect, and recklessness of character, 
induced by associations almost impossible to avoid, under existing ar- 
rangements, when very much reduced in pecuniary circumstances. 

Suppose a respectable mechanic or merchant reduced by unavoidable 
misfortune to penury. He mUst leave his comfortable home. Accus- 
tomed to fulfil his promises, the least possible promise for rent will, 
in his opinion, be the best arrangement for the present ; and, however 
the hearts of those accustomed to domiciliary cleanliness and comfort, 
may sicken as they enter where twenty or more families are domiciled 
on the same lot, with passage and yard conveniences common to all, 
yet they will make a virtue of necessity — it is a shelter — its walls en- 
circle all now dear to their hearts — and most prized of all, perhaps, 
because it hides them from their acquaintanees of znore prosperous 


days. They, of course, purify their narrow home, and, as far as may 
be, make it comfortable. When weary nature must have rest, their 
one room, which has setved both as kitchen and parlor, muiit also be 
their place of retirement. 

What modesty would recently have shrunk from, must now be sub» 
mitted to, and once submitted to, is ever after less and less painful. 
Then commences a deterioration of moral perception. It is impossible 
for one, of so many families, to keep the places common to all, dean 
and orderly ; and what is habitually witnesised in the halls and the 
apartments of neighbors, will soon be permitted, for the present, in 
their own, especially as none accustomed to other appearances will pro^ 
bably be their yisitors. 

This downward course is so rapid, and the result so certain, that few 
vrill discern the cause. Yet as the influence of this physical and 
mental condition upon the moral susceptibilities, may not be so appa- 
rent, there may be a necessity for saying, in answer to your first in* 
quiry — that I have observed a depreciation of susceptibility of moral 
and religious teachings, towards either extreme of society ; but as the 
poor are more accessible, my opportunities have been almost exclu- 
isively confined to that extreme. With this explanation, I answer, un-» 
hesitatingly, that I have observed, with, perhaps, no more than the 
usual exceptions to a general rule, a graduation of appreciation of mo-» 
rals and character, according to physical condition. And in answer to 
your second, that I have often found an obtuseness of perception induced 
by physical condition, i an insuperable bar to moral and religious instruc- 
tion. And to your third — that I have no doubt that domiciliary and 
personal cleanliness would increase self-respect, and an aptitude to 
receive moral and religious instruction, while their negligence would 
diminish them. 

To your fourth and fifth inquiries, I may be allowed to answer, that 
compulsory measures in relation to domiciliary arrangements are ordi- 
narily, peculiarly unwelcome, especially to the poor, who are usually 
jealous over what they conceive to be their now too circumscribed 
rights. And yet so little of the responsibility of the accumulated im- 
purities of their crowded habitations rests on a single family, that I 
think I may say in answer to your sixth inquiry, that the majority of 
them would be glad to receive official aid and instruction. There are, 
probably, but very few who do not think they would be glad to live 
more cleanly, if their neighbors would render it possible by doing so 
too. Any improvement, although constrained, would undoubtedly in- 
crease their relf-respect, and, of course, their happiness, and facilitate 
the efforts of those who are endeavoring to advance their spiritual 

Most of the cases of which I have kept any record, would rather 
illustrate the influence of improved morals on physical condition. And 
yet there is no doubt of their reciprocal influence. Not unfrequently, 
the commencement of the elevating process is the relief of some physi- 
cal distress, such as feeding the hungry, clothing the naked, or healing 
the sick, by the use of such means as the benevolent supply ; always 


endeayoring to keep before the mind those ereat truths on which we 
reljy through the efficient agency of the Sj[Mnt, for moral renovation. 

As an illustration of the depreciating process alluded to in your first 
inquiry, I recollect a case in point, although not recorded. An intimate 
friend of mine was acquainted with a young lady, about thirty, years 
ago, then moving in good society, with moral susceptibilities, and a re-* 
fined, discriminating sense of propriety, somewhat above mediocrity. 
At nbout the tge of twenty-two, she married, as was thought, respec- 
tably. A few years proved that the husband's morals and habits were 
not such as to secure respect or independence ; and they gradually 
sunk, and my friend lost sight of them. 

About six years since, a child was brought by a Tract visitor, from a 
filthy^ cellar, and put into the Sabbath school class of my friend, who, 
upon learning the name of the child, visited the mother, and found her to 
be the same person known years ago as a young lady of refinement. 
She had now lost all ambition ; her husband was a worthless inebriate ; 
her children, with countenances of promise, were, like their mother, 
completely at hom^ in their most miserable apartment, rendered ex- 
ceedingly so by neglect. Her moral susceptibilities were as entirely 
changed as her physical condition. Religious truth seemed to make no 
impression upon her mind — her heart seemed callous. Speak of her 
early life, and the fountain of feeling seemed to break up, and the tears 
would flow. A deep impression rests upon my mind, that lost as she 
was, if she could have been placed in circumstances of comfort and 
cleanliness ^proximating to those of her youth, the probabilities would 
have been in favor of her moral renovation. As this was beyond my 
reach, attention was turned to more hopeful cases, alas ! in too many 
instances to meet the same disappointment from the same caus^, and 
she was iagain lost sight of. Truly, yours, 

J. H. BuLtN. 

Drpm Rev. Jsaae Orchard, Mistionary oftiu 16th Ward. 

Bedford Street, AnguBt 20th, 1844. 

Dr. Griscom,-'— Dear Sir — In relation to the questions you have 
proposed, £ would group together the Ist, 2d, and 3d, as relating to a 
prevalent evil, and the 4th, 5th, and 6th, as relating to a proposed 
remedy ; and this I do the more readily, Wcause the points suggested 
under the former class, appear to me to be almost self-evident, and the 
remarks I may make upon the latter class, may be more conveniently 
made upon the three questions collectively^ Vhan singly. 

Ist, 2d, and 3d. The ejttent, concerning which the first question in- 
quires, is, I fear, very great, and frequently lea^ to actual evU. To the 
points suggested in these questions, I would give an affirmative answer, 
regarding them all as general rules, liable to some exception. Thus a 
person of coarse mind and manners may be found associating with the 
refined and polite, or a refined and poUte person with the ill-behaved 
and uncouth ; but it is not there we would seek for them. Apply- 
ing whatever experience I have obtained on this subject, I am induced 
to regard it as a general law of our nature, that minds and manners 


ahould iidce aa impreM from thoio with wUeh ihisf-maodtHe ; Md'tbis 
in iMinfiilly evident in mai^ caaei. where we obecSrTe thoie who here 
ftllevfroQi opttlepce, floihioti, maa hwh stiQdtdj;, into poverty. ' Sup- 
pose a ladj, aceattomed to }uxmy taA elegAnt aoeiety, so reduced that 
ahe has to earn her liring by labor, and neeeasarify to min^ltf amongst 
the poor. You mqr aee traces of her former condition; yet they'will 
be but little more than traces^ Compelled to bring her mind to her 
eireumstanoesy to associate with, and perhaps recei«re in^trucHon from, 
persons whom she once would haye avoided, she inmk either be soli- 
tary in her manners, oi^ despised as seeking pre-eminence, or she orast 
come down to the standard of those around her, and the last di these 
will be, in mdst cases, preferred, although it wiU involre a great dimi- 
nution of self-respect, 'When independent in foHune« dmt pers6n felt 
independent in mind, and abhorred any thing tnean — but when' lauded 
to dependence upon another for bread, or even for labor,' lind seeing 
that the most obsequious obtain the most smiles, then the cravings of 
want will humble the high spirit, a^id self-interest will induce that per- 
son to submit to the meanness of obsequiousness, although subjecting 
herself, at the same time, to the most painful feelings and sdf-rsproaeh. 
It is evidently very difficult, almost impossible, m persons in general 
to avoid the influence of physical condition upon mind. Thuif it is 
with those who have sunk from an elevated position, and it will be the 
same with those who have sunk from aa humble' position to one still 
lower'. Pisrhaps Uie minority of charity seeking persons amongst us, 
may be of 4iii class ; they were never rich, but perhaps were quite 
above want ; now thq^ have sunk in cireiimstances from wjme cause, 
and the associates with whom they mingle are of a lower grade than 
in former days. This they do not know bow to. avoid, for these are 
now their neighbors. To keep on good terms with them, they mingle 
in their company, unite in their sentiments, and associate in their vices. 
To some passer-by, it appears, strange that in the block standing 
south of the Catholic Cathedral, and other places contiguous, there are 
so many gin-shops ; and they ask where are the customers to support 
these shops ? They cannot be in the neighboring houses, for there also 
customers are wanted — the bottles are exhibited in house after house, 
and I have known two such shops in one house ; — whence came the 
customers ? Now this is a question that the licensing power might 
have asked before they granted their license to sell, and there would 
have been nothing ultra in it, however ultra might have bten the ques- 
tion, whether or not such sale should be licensed at all ? But in the 
multiplicity of cases, it is evident the good fathers of the city forgot to 
ask the question. Is it possible that a Catholic Cathedral, like a thea- 
tre, can be the attractor of a circle of gin-shops ? No ! no ! to suppose 
that these shops are sustained by the worshippers at St. Patrick's, 
when going to, or returning from church, would be very unkind, and 
perhaps very unjust ; for I have discovered that those houses contain, 
to a considerable extent, their own customers. It is unquestionably 
true, that when persons sink into poverty, they do not like to be 
scowled upon — they feel it even more than in better days-^yet people 


will icowl upon them ; their old friends and acquaintances will avoid 
them, lest they should want something. Landlords will be more par- 
ticular than ever as to their rent, and when they have got it, not be 
respectful, and scarcely civil. Some benevolent person calls to inquire 
as to a poor fiunily needing aid — ^the landlord says nothing that will 
help them, and the room appears (in the estimation of some short- 
sighted philanthropists) too good for a family receiving charity, and 
besides there are several articles of decent furniture — the visitor is 
dissatisfied, and leaves, but leaves no aid behind. The broken down 
spirit is prostrated — hope is blasted — in a little while the few decent 
articles are gone that food may be obtained, and the poor, dispirited 
castaways seek a refuge where all, being poor, will sympathize with 
each other, and where, the landlord, even if he charge higher rent than 
they gave before, will speak soothingly, and though he advise them 
to drown their cares in whiskey, will be very faithful in giving them 
an excellent character to all inquirers. Lodgings for such persons, on 
such terms, may be found in the houses 1 have described. These 
houses contain^ I say, to a large extent, their own customers ; for they 
are the pauper's rendezvous, and offer lodgings to beggars of every grade. 
They seem to be always open for new comers, and ia some way or 
other they cad accommodate them. There are various neighborhoods 
of this kind in this city, and I have called your attention to the one 
named, that I may give you an illustration of the remarks I have made. 
In one of these houses, in a garret, with sloping roof and low ceiling, 
one small, broken window, no bedstead, nor other bedding than a few 
bundles of rags upon the floor, 1 have found three families of men, 
women, and children : there they lived, and there they all slept. Now, 
if a woman accustomed to humble life, or decent poverty, be con- 
strained to remc^ve to such a place, what must be the effect on her 
mind, her morals, and her habits ? At first, she will recoil from un- 
dressing in the presence of a strange man, but soon she will do it 
without a blush. Is she a wife } There are other wives and their 
husbands in the room, without even a curtain to hide the most private 
transactions. That which transpires cannot be unobserved, though 
seeking the darkest recess, and soon it will be imitated without secrecy 
and without scruple. Children, too, will see them, and think, and 
imitate — and thus become depraved in their thoughts, desires, and 
practices. Can any one doubt that there must be rapid declension in 
morals, in both parents and children ? or that a bar is here opposed to 
moral or religious instruction ? or that this state of things was centre* 
quent on the circumstances and condition of life 1 Beside this, persons 
living thus, are almost necessarily drunkards, whether men or women. 
Drunkenness, probably, reduced them to this state, but if it did not,^ 
the landlord would hardly allow them to remain in the house, or their 
fellow lodgers, in the room, unless they became such. If questioned 
upon this subject, they are accustomed to reply that they do drink, but 
not too much ; yet the question, what quantity is too much, is one 
upon which their opinion and mine would not agree. When the 
visitors from the City Tract Society, with whom I am accustomed to 


act, succeed in awakening in the minds (jf such persons a sense of their 
degradation, their first care is to cut them off from, the society that 
misery loves. If, then, they can be induced to break o£^ from their de- 
based habits and associations, and to keep themselves and the clothes 
they give them, clean — and especially, if they can he induced to woikj 
then some hope is entertained that they will listen with attention to 
religious instruction ; but not till then. 

4th, 5th, and 6th. As to the remedy proposed for these evils, I think 
there can be no doubt that if the love of cleanliness could be instilled 
into their minds by moral means, all the good you suggest would result 
from it, and real good would result if cleanliness were secured by any 
means ; but I think it very problematical whether this could be obtained 
hy coercion. Unless the will assents, there must be constant evasion, 
and but little will be accomplished. There is that in the nature of 
man which will induce him to respect advice, if it be given with evi- 
dent kindness, respect, and disinterestedness, but to reject real benefits 
if they be forced upon him against his will. The poorer classes often 
imagine that they possess rights which they do not, and joio persons are 
more jealous of what they deem their rights than these persons ar^ or 
more ready to resent and oppose, any infringement of them. 1 hold it 
to be a sound principle that no one has a right to do wrong ; but many 
would dispute this, or if they admitted it, the question would arise, 
what is wrong ? I regard it as wrong for any family, by neglect of 
cleanliness, to surround itself with a fetid atmosphere ; but there are 
multitudes of the poor, or rather that class of the poor particularly in- 
terested, who imagine they have a right to do as they please in this 
matter, and that it would be a wrong that should be resisted, if any 
one interfered with this right. It seems therefore necessary, as a pre- 
liminary measure, to correct the judgment, for it is not that which a 
man ought to believe, but that which he does believe, that regulates his 
conduct. If this be not done, will he not regard what you propose, 
as a high-handed measure of the rich for the oppression of the poor ? 
And if the poor man's shanty be visited more frequently than the rich 
man's mansion, will he not regard the law as partial and unjust, and 
probably as unconstitutional } And if this estimation of the law prevail, 
can it be carried into effect ? It requires something more than legisla^ 
tion to convince the judgment, and no legislation, though based upon the 
soundest principles, will be generally respected, if it be opposed to popu- 
lar error. I can imagine that there are many who would be glad to 
receive the visits of a health officer, if he were gentle, kind, and un- 
officious — if he had the confidence of the family, and if he caused all clean- 
ing and improvement to be done without expense or inconvenience to 
the tenant — but not else. I have been accustomed to visit the poor 
during the last forty years, and experience convinces me that if a 
wealthy individual, when bestowing a gift, find fault with the dirtiness 
of a place, he must do it with gentleness, and with due regard to feelings, 
and with no assumption of superiority, or he will exclude from the 
mind all sense of gratitude for the gift bestowed. Or if the person com- 
municating kindness be known as the almoner of others, everything 


like scolding, and bluster, and importance, will be still more offensive ; 
and thotigh regard for the yet ungiven dollar that he holds between his 
fingers, may preserve the peace until he leavea the room, then will 
there be a bursting forth of pent-up indignation ; and though at his 
future visits he may be received with civility,* it will be the civility of 
hypocrisy. How then can we expect that the official intrusion, without 
a peace-offering, of a public officer into the place which, however poor, 
the poor man calls his castle, will be received with favor ? He may, 
indeed, be clothed with legal authority to enter the place, and there to 
look into holes and comers, enforce the scrubbing of the floor, the liming 
of the walls, and the cleansing of the furniture, and oblige the woman 
to wash herself and her children, comb their hair, and scour their clothes ; 
and all this may be important to the welfare of the family, and the 
health of the neighborhood — but it will be more likely to cause a 
breach of the peace, than to be regarded as a kindness. 

There is a power somewhat similar in England, given to the gover- 
nors of the poor ; but in that country, under monarchial government, 
rights are onen proportioned to property ; laws are made to benefit or 
coerce distinct classes, and strength is given to the government ^v cloth- 
ing it with vast powers to be used whenever discreet — that is, m cases 
of urgency. So with the law ; the spirit of Englishmen would not sub- 
mit U) the evenr day enforcement of the power it eives, apd therefore 
it is not to be round in every day life, but in the Statute book, ready 
for use in ^ase of pestilence, or other apparent necessity. Then such a 
law would be really valuable. They have it in reserve for such a sea- 
son, and it might be well if we had a similar law to be used under simi- 
lar circumstances ; for then, the judgment of every one showing its 
importance and necessity, it would be enforced witbout difficulty. Of 
this we have an illustration in the operation of quarantine laws. The 
great plasue of London, caused by the arrival in the port of an infected 
cargo of hides, and various other ca^es, have impressed on the minds 
ci men the horror of a plague, and the great danger of its being so in- 
ilroduced into a city or nation. Hence, every one sees and feels the 
Aecessity of a ship being inspected ; yet that inspection is not hailed 
with pleasure, but submitted to as a necessary evil. Such, at least, I 
liave found to be the case ; and I was one of about 160 persons who 
terminated a tedious and almost suffocating voyage at this port, while 
xholera was raging both here and in Europe. The same acquiescence 
m domestic inspection could be secured, I presume, only in the same 
•warv— that is, by the judgment being convinced that the measure is just 
And necessary. But how is the judgment of men to be so convinced, 
;and especially In a season of general health } Not by the enactment 
x>f a new law giving new powers ; but by moral means. If we had an 
Awful pestilence, and all the phvsicians united in declaring its cause to 
bave been the filthiness of the dwellings of the poor, it would no doubt 
produce an impression — though perhaps even then conviction would not 
pe produced unless dicta were sustained by demonstration. 

Yours, very truly, Isaac Orchard, 

S0O. of C. T. Society, and Missionary of 15th Ward. 


There is one other aspect in which the relations of the state or com* 
munity, to its citizens, are to be viewed, which cannot )be omitted here^ 
without doing both parties injustice,^ especially as in thia connexion, the 
relation is very intimate, as well as important I refer to the depen- 
dence of the community upon, the labors of its members, for its prosperi- 
ty, support, and advancement. The influence exerted by a single indi- 
vidual upon the character and capacity of a government, is well marked 
and freely acknowledged, when men of commanding intellect step out 
from the common ranks. No one, for example, can measure the degree 
of influence exerted upon the character of this country, or of mankind, 
by Washington, Franklin, or Fulton, or upon the prosperity oi this state 
by the genms of Dewitt Clinton. And so on downwards through the 
various gradations, and the ever varying abilities, physical and mental, 
of the masses of individuals, to the most insignificant, it is impossible 
not to see that each one possesses more or less influence upon the con- 
dition of the community, and by his peculiar labors, adds to it, or saves 
for it. How many conflagrations have been prevented by the devotion 
to his calling of the sooty and despised chimney sweep ? while thou- 
sands of dollars have beeU rescued from filth and nothingness, by the 
industry of the degraded Chiffi)nier.* 

Now, a ^at part pf the wealth of the community consists in its 
physical labor. ^' Labor is wealth." The. manufacturer, the artisan, 
the builder, a//, depend upon the skill and strength of those employed 
to do their work. Who then will say that labor of the most insignificant 
kind should not be protected, improved, and facilitated, that the laborer 
of the smallest capacity should not be strengthened to the utmost, bj 
careful training and education ? It very often happens that almoet the 
minutest muscles of the human body (those of tne hands and fingers) 
are those which perform the most important and delicate work ; so do 
we frequently find the most essential part of a magnificent structure, as 
of an engine, or a building, requires the labor of the poorest and roughest 
operative. Sound vigorous health is an essential pre-requisite to the 
proper performance of all labor. 

The following passage, from an author before quoted,! written for an 
analogous subject, is so directly applicable, so appropriate to my pur- 
pose, and so forcible, that no apology will be required for its length. 

'^ This subject has merits which should command the attention of the 
statesman and political economist. All investments to preserve or in- 
crease the public health, would be reimbursed many fold, in an increased 
capacity for production. One of the most important items in a nation's 
wealth, consists in the healthfulness and vigor, enjoyed by its people. 
All agriculturists and manufacturers must feel the force of this remark 
in regard to their own workmen ; and they would feel it still more, if 

* As an instance of the perseverance and frugality of this class of operatives, I 
was lately informed of one who, by his dirty trade, has amassed ^400, which he was 
about investing in Western lands; Hundreds of these people derive a good support 
from the business in this city. 

t Hon. Horace Mann. — Sixth Annual Report of the Board of £ducaUon of Msasa- 


they were obliged at their own e^cpense to support those workmen 
daring all periods of sickness or incapacity to labor ; and this is the 
relation in which the state stands to its citizens. It has been said 
by some writers on political economy, that from one^seventh to one- 
eighth of all the wealth of a country originates io the labor of etich 
year. Hence, if any nation or community should cease from production 
for seren or eight years, the whole of its wealth', — houses, lands, 
goods, money — would be consumed. What a forcible idea of the 
yalue of labor, is presented by this &ct ! Yet, what a sick workman 
or operative would be to a capitalist who was obliged to maintain him, 
« sick citizen is to the republic. Every sick man, every man rendered 
unserviceable by general debility, or specific ailment, must be subtract- 
ed frpm a nation's available resources. He not only adds nothing to the 
common stock, but he draws his subsistence in some form — and often, 
too, a very expensive -subsistence — from the storehouse which the in- 
dustry of others has filled. Omitting all considerations of personal and 
domestic suffering, of the extinction of intellectual power, and of those 
moral aberrations which originate in physical derangement and disease — 
and considering the race under the mere aspect of a money making 
power — in this respect it is clear that the health and strength of one 
community, if set in opposition to the debility and infirmity of another, 
would be sufficient not only to determine the balance of trade, but to 
settle all other points of relative superiority. Let such information be 
diAised through the public, as all the children in our schools might 
easily aoauire, and a single generation would not pass away, without 
the transfer of immense sums to the other side of the profit and loss ac- 
count in the national leger. Of course, I do not mean that all diseased 
could be abolished at once, even by a universal diffusion of a knowledge 
of theur causes ; or that the era foretold by the prophet would be usher- 
ed in, when ^^ the child shall die a hundred years old," and when there 
shall be no ^* old man that hath not filled his days." The violation of 
those beautiful and benign laws which the Creator has inwrought into 
our system, has been too heinous, and too long persevered in by the 
race, to be expiated or atoned for in a single age. Diseaee and debility 
transmitted through a long line of ancestors, have acquired a momentum 
by the length of the descent, which cannot at once be overcome. But 
I do mean, if this subject were generally understood, that such a change 
would be wrought- in a single generation, that a broad and deep current 
of wealth would be made to change its direction ; and instead of millions 
annually flowing outward from the common treasury, to defiray the 
various expenditures of sickness, that treasury would be replenished by 
an equal number of millions, coined from the mint and firom the ore, 
of labor-lovine health. Yet amid all our pecuniary speculations, this 
grand financiu operation, of substituting health and strength for sick- 
ness and debility— that is, immense gains for immense expenditures — 
has been unheard of. 

^' In the army and navy, where theexpediency of giying battle hasbeea 
discussed in a council of war ; or afterwards when the causes of defeat 
have been explained by the vanquished, the state of the sick list has 

LABOftnro POPtnuLtKm 09 inw irosK. 4l 

been made die mibjeet ct {nqiiiiT. The historiin, too, in his aoeoimt 
of canpaigm, teoofpisBCB health and aickiieia aa among the grand 
oauaea ci saeteaa or diaaater. Bot the manly health aim tifpt of a 
people engaged in the arts of peace — as among the moat essential it^ma 
m a nation's Taloationy as a <3i^tal ready for profitable investment, in 
way industrial enterprise, and therefore as a prolific sonroe of public 
reyenue,a8 veil as of private wealth, have been overlooked by states- 
men and law-givers, in all their schemes for national agmndisement; 

** The pecuniary merits of this subject may be presented under another 
aspect. Children at different ages, and under different circumstances, 
may be regarded as represientiim mvestments of diflbrent sums d. money. 
These iuTestments consist in tne amount which has been expended for 
their nursing, rearing, clothes, board, education, and so forth, uid in the 
value of the time of others which has been appropriated to them. 
Though differing exceedingly in regard to different persons, yet, in thn 
ooufttiy, the aggregate expense wim its accruing interest, m the great 
majority at the age of twenty, or twenty-one years, can hardly be esti- 
mated at less than firom five hundred to a thousand dollars, after deduct- 
ing the value of dl the services performed. Now if half mankind die 
by the time they aitive at this age, or before it, and half these come to 
their untimely end, through the ignorance of their parents or them- 
selves, (and 1 may add through the inattention of government to their 
condition,) what an amazing price does our ignorance (and inatten- 
tion) coat US'? With what recUess prodigality do we continue to 
cherish it ! Whiit spendthrifts we are, not only of the purest source 
of af^tion and domestic hamriness, but of wealm !" 

Such being the condition of a great pitrt of the population of this city, 
such the physical, and such the moral evils, which flow in a continu- 
ally deepening and widening stream of misery, pollution, and death, it 
remains for me now to point out, in conclusion of the plan with which 
I commenced this paper, the means by which the sources of the current 
may be dried up. ^ 

To secure the community against invasion by disease from abroad, 
we have a well organized and efficient ^^ Gordon Sanitaire.'' This con- 
sists of the Health Officer, residing at the Quarantine station, and the 
Resident Physician and Health Commissioner, residing in the city. 
These together form a board known as Health Commissioners, and in 
conjunction with the Board of Health, (composed of the Mayor, Alder- 
men, and Assistant Aldermen,) constitute the external Health Police. 
No vessel can reach the city without an inspection by the Health Offi- 
cer, who has fall power to determine whether she has on board any 
material, or comes from a port in such a state of health, as misht pro- 
duce disease in the city after arriving at our wharves. Should he dis- 
cover good cause to suspect her to be in a condition dangerous to the 
public health, he is empowered to detain her at the Quarantine, a length 
of time sufficient to overcome all danger therefrom. The law is impe- 
rative, unless the Board of Health, for good and sufficient reasons, choose 
to permit the vessel to approach the city. The Health Officer has full 
control over the persons of the officers, crews, and passengers of vessels 


■UBpected of infectioD, and over the cargo, and all the properties of the 
vessel and passengers. Certain articles may be destroyed by him, and 
he may order bedding and clothing to be purified and washed, before 
beine brought up to the city. 

These officers are all appointed by the Governor of the State. The 
city authorities have no voice in their selection, though the Resident 
Physician is to a certain extent, subject to the direction of the Board 
of Health. The only medical duty prescribed for him by the law, is 
to ^' visit all sick persons reported to the Mayor, or to the Board, or 
Commissioners, of Health, and perform such other duties as the Board 
of Health shall enjoin." '' The Health Commissioner, under the di- 
rection of the Board of Health, shall assist the Resident Physician in 
the discharge of his official duties." 

These officers, it will thus be seen, belong exclusively to the external, 
and not to the internal Health Police of the city, except so far, or at 
such times, as the Board of Health may direct. With the investigation 
and removal of causes of disease, and the suppression of epidemics gene- 
rated, and existing within the city, they have nothing to do, unless 
ordered specifically by the Board of Health. Under present circum- 
stances, the Board having no municipal officer upon whose knowledge 
and judgment in such matters they could depend, the state officers, 
would undoubtedly have plenty to do, should occasion for extra services 
unfortunately arise. 

This I repeat is our external Health Police ; and it will be generally 
conceded to be well arranged, ample, and efficient. All the incumbents 
are medical men, and care has generally been taken to appoint those in 
good standing in the profession, and possessing sufficient age and ex- 
perience. This is the more commendable, as nearly all the duties of 
some of the officers are merely financial, yet the incumbents may be, in 
the event of an epidemic, called upon to exercise their professional judg- 
ment and skill. 

It cannot be denied that from within the confines of the city, more 
'serious danger is to be apprehended than from without. In the pent 
up courts, the crowded tenements, the narrow streets and alleys, the 
damp dark cellars, in the destitution, filth, and misery of a large part of 
our population, are the germs of disease, which will readily account for 
a large proportion of the weekly average of nearly 200 deaths, announ- 
ced in tne bills of mortality. 

In geographical poHtionj in cUmatit placement^ and in geological $trw> 
turej no nte perhape could be selected for all the pitrposea of a great city^, 
of a more aabdnioua character j than Manhattan Island. And yet whence 
this great mortality ? It is not from without — disease is forbidden to 
approach our wharves. It can only be then, from within, the people 
meet with such abundant destruction. Many of the immediate causes 
of this I have endeavored to point out. The remedy and preventive, 
are next to be considered, and I will now invite attention to our Internal 
Health Police. This consists of an officer entitled City Inspector, an 
Assistant City Inspector, an Assistant to the Board of Health, and eigh- 
teen Health Wardens. For 15 or 20 years past, it has been deemed 

LABOBnra POPULATioir or nw torx. 48 

importtiit tbat the Citj> Inspector, (who standi in the rektion of • head 
to this corps of officials,) shoald po s s e ss medical attainments aiMl q<iali-' 
ficationsy ioasmoch as many of his duties prescribed by ordinance, and 
many others not prescribed, aee of a character requiring that kind of 
knowledge for their perfennanoe. In the last appointment, howe?«r;to 
this office, thisyineinle was rpjuidiitrH fopmasons not veiy eUarly-sel 
forth ; it might haye been considered as an orenight, had not an oppor* 
tanity been given for a rerision of the act, by the pvesentation of a 
memorid on the subject, by a very large number of raediod practi- 
lioners, which set forth in a clear light, the true nature of the office, and 
the necessity of a medical' education in its incumbent, and which memo- 
rial was not only responded t(^irorably, but its prineij^ea denied in the 
report of a committee appointio to consider the subject. The propriety 
,of the appointment was insisted upon, and the sentiment was expressed, 
that not only is a medical, or even a literary education in die officer, 
unnecessary, but that without it, in the language of the report, ^ he is 
likely to prove equally, if not more, capable and efficient." I have no 
wish to criticise this remarkable exposition of a principle vrhioh must 
strike every one who obtttrveB it, as entirely out of character with the 
present advanced state ai intelligence. • 1 will) however^ endeavor in the 
proper place, to show that a medical education is essential to the proper 
discharge of the duties of an officer of health, of whatever grade, ana of 
Uiis one especially, and that the ^atest care should be exercised in 
sdecting those best qualified for this duty. The Assistant City Inspec- 
tor, and Assistant of the Board of Health, need not possess medical quali- 
fiKsations, as their duties are more strictly clerical ; yet such an educa- 
tion would often be useful, as they sometimes are obliged to act in ihe 
absence of the chief officer. 

Nor has it ever been deemed necessary that the Health Wardens 
should be medically qualified. Indeed, bad it been, medical m^n could 
not readily have been obtained for the duty, as conjoined therewith, is 
an office whose duties are of a totally different character, and entirely 
irrelevant to the habits and educational capabilities of a physician. I 
allude to the office of Dock Master, and lately, the office of Street In- 
spector has been added to it, in some of the wards. 

Being one of the poorest offices in the gift of the Common Council, 
the post of Health Warden has rarely been sought for, or filled, by 
any other than the most ignorant and incompetent among the office- 
seekers. Its salary being the smallest of all, the most shameful collu- 
sions have been, and are daily, practised, for the purpose of increasing 
the emoluments, whereby a large amount of money' is irregularly and 
improperly taken from the pockets of citizens.* Another serious ob- 
jection to the present arrangement is, that during the prevalence of 

* By the City Inspector, in 1842, a fraad was detected, which, had it proved suc- 
cessful^ would have swindled householders of a large amount of money. It con- 
sisted of the printing of two hundred forged notices to empty sinks, which some 
night scavenger had ordered, and which would have yielded|hira from ten to thirty 
dollars each. This was but one operation, and there is reason to believe that such 
BCts are frequently committed, with the connivance of the Health Wardens. 


epidiSmic or contagious diseases, in large numbers or single cases, the 
timid apprehensions of non-professionsl men, often wholly unfit them 
for the duties of officers of Health. They fear to approach a sick per- 
son, or even to enter a house where the disorder is said to exist, and 
they are more likely to increase, than allay, popular excitement. Some 
other equally injudicious matters, in this connection, might be stated, 
but these facts alone must be sufficient to convince any one of the utter 
inefficiency of the present system as a Health Police. Not one of all 
the offieer$ in that important branch of the City Oonemmtnty is now oc^ 
cupied by a medically educated man. 

Allusion has been already made to a plan of a Health Police sug- 
gested nearly two years ago. There are three prominent principles 
upon which an organization for this purpose should be based. 

In the farMt placej the incumbents should be men whose education, 
habits of investigation, and powers of judgment, would enable them 
to determine what constitutes a nuisance, and how far any particular 
matter is calculated to derange the healthy state of the atmosphere, — 
in short, they should possess a good knowledge of the doctrine of mi- 
asmata of all kinds, and their influence upon health. 

2d. They should be men whose daily occupations, and, if possible, 
their personal interests j would aid them in the discovery and suppres- 
sion or removal, of the causes of disease : whose seneral intelligence, 
and regard for the welfare of the city, and especially of its poorer in- 
habitants, would induce and urge them to give a regular and thorough 
examination of all suspected and doubtful places. 

3d. They should possess the qualifications tor reporting, when re- 
quired, to the superior authorities, the sanitary condition of the various 
sections of the city ; — ^for recommending such measures as prudence 
and enlightened judgment may dictate, and the practical skill requisite 
for the application of preventive measures, such as vaccination and the 

All these principles and aims would be answered by the adoption of 
the following plan of organization. I propose forsty to abolish the 
office of Health Warden^ (o{ whom there are usually eighteen ;) to 
divide the city in twelve districts, to each of which to appoint a re- 
spectable physician, to be entitled Health Inspector. These twelve, 
with the City Inspector and his office assistants, to constitute the 
^< Health Police of tbe City of New Yoik," the City Inspector, (also a 
respectable physician,) to be its head. 

I need not enlarge here upon the benefits derivable firom a reduction 
of the number of officers. 

To obtain the advantages of the 2d principle, that is, to engage the 
personal Bxxd private interest of the proposed Health Inspector, (wberein 
we would have the best surety for the faithful performance of his du- 
ties,) I propose to make the boundaries of the Health districts identical 
with those of the present Dispensary districts, and to unite the offices 
of Health Inspector and Dispensary Physician, in the same individual. 

The duties of the Dispensary Physician carry him in the very track 
of tbe nuisances which should be corrected, and while administering 


lo the relief of his patients, he would, as Health Inspector, cast about 
for the source of the evil, and apply the remedy. By the performance 
of his duty in one capacity, his labors in the other, would be mate- 
rially lessened. 

How great a proportion of the Rheumatisms, the Fevers, the In- 
flammations, the Pulmonary and other disorders, of all kinds, are at- 
tributable to the damp cellars, the filthy tenements, the foul yards, 
courts, and alleys, in which the poor are crowded, can be known only 
to the Dispensary Physician, who spends much of his time amid these 
wretched scenes, where he is now powerless for any preventive action 
that may occur to him. 

But all are aware, for bitter experience has shown, that it is in those 
places the Cholera, Yellow Fever, Small Pox, Scarlet Fever, Measles, 
Typus Fever, and all other contagious and infectious disorders, are par-^ 
ticularly abundant and malignant. 

It has been customary upon the breaking out of an epidemic, for the 
public authorities to use great exertions and spend much money in 
cleansing and purifying these pestilential spots, in order to arrest the 
extension of the disease. Their previous neglect, or a false economy, 
has repeatedly sown a wide-spread desolation, which such preventive 
measures, as are now suggested, would to much extent have saved. 

In addition to the duties now performed by the Health Wardens, 
the Health Inspectors should be required, 

1st. To see that all persons are vaccinated, and for this purpose, to 
visit all houses, especially among the destitute, once a year ; to be con- 
stantly prepared, and to offer their services, to perform the operation 
gratuitously, and to urge it upon all who may require it. 

2d. To be subject to the requisition of the Mayor, or any Alderman, 
or Assistant, to perform any professional duty they may justly require ; 
the Health Inspector, in whose district may be a Watch House or Po- 
lice Office, to perform all the medical and surgical duties that may be 
required at those places, at the call of any officer attached thereto ; and 
to do all other things that may be required by the City Inspector. 

The performance of the duties of this last section by a municipal 
officer, it will be at once seen, will relieve the Common Councrl of all 
the annoyance attendant upon the examination, and passage or rejec- 
tion, of the numerous small bills now frequently laid before them. 

It is evident that under such an arrangement as this, the duties of 
the Dispensary Physician would be performed with a greater degree of 
cheerfulness and care. The stimulus of a better remuneration, with- 
out the addition of any other duty than such as would tend to reduce 
the amount of his professional labors, and of a character not merely 
not incongruous with, but really in aid of, those labors, the duties of 
both offices requiring generally but a little more time than is now given 
to one,, there could be obtained for the joint office, men of such char- 
acter and age, as would not only prove a blessing to the poor, but a 
great assistance to the higher authorities, and give a profound satisfac- 
tion, and feeling of every possible security, to the whole community. 

Not the least among the advantages derivable from the proposed 


combination^ is this, that this corps of pn^essional men, (selected as 
they are, and doubtless ever "wili be, by the trustees of the Dispensa- 
ries, as those best qualified, without the slightest reference to political 
opinion,) being ex officio Health Inspectors, though commissioned as 
such by another power, (the Board of Health,) if found competent, 
the Department would be at once raised above the corrapting atmos* 
phere of partizanship, and we should then no more hear of public du- 
ties neglected for fear of making a politicel enemy, or through favor to 
a political friend : a practice too prevalent in this Department under its 
present organization. 

In the protection of public health, as well as in private practice, 
party zeal should be entirely repudiated : it is incompatible with sound 
judgment and efficient action. 

If any one Department, either of government or of private occupa- 
tion, (and the remark has as much weight in one case as in the other,) 
shoula, more than another, be above the influence of political &voritism, 
and be sustained upon its intrinsic merits, it is that which has the care 
of the lives and health of the community, or of individuals. 

From what has been related respecting the effects of the habitations 
of the poor, upon their health, lives, and morals, the evils are attribu- 
table to three things, viz., 1st, the living in damp, dark, underground, 
and other ill-ventilated apartments. 2d. The diity and injured condi- 
tion of the floors, walls, yards, and other parts of the premises. 
3d. The crowding too many persons in single rooms of inadequate 
size and accommodations. To correct the first two of these evils, 
there appears but one way, and that is to place all the dwellings of the 
city under the inspection of competent officers, who shall have power 
to enforce a law of domiciliary cleanliness. For this purpose, those 
places known or suspected to be kept usually in improper condition, 
should be visited periodically, say once in one, two, or three months. 
The law should be so arranged as to make the cleansing bear upon the 
owner or lessee, and not upon the tenant directly, who is generally so 
poor, as to be unable to perform the necessary purgation a^nd rectifica- 
tion of the premises. 

The provisions of such a law should be similar to these. 

1st. Every dwelling, or house, or room, court, alley, or yard, or 
other place used as a dwelling in the City of New York, shall be sub- 
ject at any time, between sunrise and sunset, to the inspection of the 
Health Inspector in whose district it may be situated. If in opinion 
of said officer, it shall be deemed unfit for the purposes of a residence, 
by reason of dampness, darkness, dirt, filthiness, too low ceiling, ill- 
yentilation, being under ground, or any other good cause, he shall im- 
mediately report the same to the City Inspector, who shall, upon being 
satisfied that such report is true, serve a notice to that effect upon the 
owner, agent, or lessee, stating the reason therefor, and directing the 
same to be put in proper order and condition, within a specified time ; 
said room, house, or premises, to be outlawed, and forbidden to be oc- 
cupied as a dwelling, until said order is complied with to the satisfac- 
tion of the Health Inspector. 


dd. Should any room, cellar, dwellingiOrprenuBes, befisiuidbyt^ 
Ifealth lofpector to be in a condition dangeroua to the pablic health, 
by reason c€ emanationi. from the soil, at other places, iM* from any 
other cause, said officer shall repprt the same to the City Inspector, 
who shall upon being satisfied of its correctness, notify the owner, 
agent, or lessee thereof, directing him to cleanse and ponfy said place 
or premises, within a reasonable time ; in default of a compliance with 
audi order, it shall be the duty of the Health Inspector to cause such 
pkce to be purified and cleansed forthwith, and all the costs to be as- 
sessed upon the property so cleansed, and in addition thereto, a fine of 
fiffy dollars. 

3d. Should any owner, lessee, or other person feel aggrieved by the 
action of the Health Inspector of City Inspector, appealmay be made 
to the Mayor^ or Board of Health, (sufficient time being sllowed for 
the purpose,) who may reverse or confirm the decision of the City 
Inspector. . 

The power possessed by the City Inspector, or his assistants, is al- 
ready sufficient for the general purposes of this proposition, such as 
entering and inspecting any premises, yard or dweUing, &c. But the 
essentia points require some addition to the law, and I believe they 
are all embraced in the above proposed provision. 

Can there be a doubt that such sanitary provisions, if well and dis« 
oreetly carried out, would have the happiest effect upon the condition 
of latge numbers of the poor of this city, and that they would prevent 
much of the devastation of hnlth and life now made among them, by 
the manner in which they are compielled to pass their days by the n^ 
ligent and unfeeling landlord ? 

The e&ct of such a law upon the habits of the tenant would not be 
direc/, — his personal condition can only be reached by the moral law, — 
but the landlord, under this compulsory process, urged by the fear of 
having his premises out-lawed would, in letting them, stipulate with 
his tenants to keep them clean, to whitewash the walls and ceilings, 
wash the floors, remove the collections of dirt and garbage, and keep 
the yards and cellars in good order. And knowing that the health offi- 
cer will pay them frequent visits, armed with the power of the law, 
it is altogether reasonable to suppose that the tenants themselve would 
be stimulated to maintain a better appearance of petsons and domicils — 
that many would feel a pride in a good and cleanly aspect — ^that the 
smothered feelings of self-respect, love of praise, and desire for the 
comforts of cleanliness, would, in hundreds of bosoms, be re-awakened 
into life and energy. 

Much of the good efiect which might flow from the application of 
such a law, would depend upon the character and manner oi the indi- 
viduals appointed to enforce it. The exhibition of a regard Ibr their 
health and comforts, a manner combining firmness, kindness, and pa- 
tience, a disposition to instruct in the manner^ as well as to require the 
act^ giving an assurance while making the visit of inspection, that it is 
wholly for their advantage, would satisfy the tenants that their health, 
comfort, and protection, against the neglect of the landl<Mrd, were the 


chief objects of the law, and cause the visits of the inspectcnr to be re^ 
ceived with interest and pleasure. No person is more likely to be re- 
ceived with kindness, and welcomed as a friend, than he who comes to 
relieve suffering, or restore health. The plan I have suggested of uni- 
ting the offices of Dispensary Physician and Health Inspector in one 
individual, trill effectually accomplish the object in view, in every par- 

The enforcement of a law to compel domiciliary cleanliness, may at 
first sight, appear to some as impracticable, to others as unconstitutional, 
(on the ground that a man's house is his castle, and his occupation of 
it cannot be interfered with without his consent,) and some may sup- 
pose it oppressive, as interfering with the rights of citizens to live a» 
many in a room, in such manner as, and in whatever room they choose. 
An examination of this subject will expose the erroneousness of such 
views, and show that an inspection of dwellings will be as justifiable as 
the inspection of articles of food, or clothing, or of steamboat boilers. 

We permit, without objecting, the examination of our houses by the 
fire wardens, to see that all is safe against fire. No one objects to the 
law limiting the number of passengers in a vessel crossing the ocean, 
and the confiscation of the vessel for its violation ; and the public voice 
would demand, in loud tones, the razing of a house in danger of falling 
upon the passers by. Chimneys are required by law to be swept every 
month, and if they take fire, a fine is imposed though no damage results. 
Gispoob and sinks are jiow required to be empti^ when the contents 
attain to a certain depth, under heavy penalty. Unsound beef, hides, 
skins, fish, or any putrid, or unsound or unwholesome substance, may be 
forthwith cast into the river by the officer. The fire law prevents the 
erection of wooden buildings within certain limits, and prescribes the 
mode in which brick buildings .shall be built. All these instances, and 
many others that might be mentioned, may be said to inirince on the 
rights of citizens, with as much propriety as the amendments nere sug- 

Sested. Nay, further, with regard to nuisances, the statute expressly 
eclares the right of the Common Council to fill vp any lots, yards, or 
cellars which may endanger by their condition, the public health, and 
the same reason why a vessel without a clean bill of health, may not 
lie at our wharves, will apply to the dwellings in the city. Every 
house should be required to have a clean bill of health, or like the ships^ 
be placed under the control of the proper officers. 

To raise from the depressed ano pooty the heavy necessity of living 
crowded in single rooms, the source as I have endeavored to show of 
great moral, as well as physical, evils, much aid cannot, I fear, be found 
in any legal enactment. If a family are so numerous as to require 
separate rooms, and so poor as to be unable to procure them, no law- on 
the subject could be enforced, which would effectually prevent the evil. 
The retnedy lies with the humane and philanthropic capitalists, by 
whom houses might be erected with all the comforts and conveniences 
of separate chambers, &c., which would yield a fiiir interest on their 
value, and make thousands of people happy. Here is a direction in 
which a fortune might bo applied^ which would produce an amount of 


to the posaeMor, of good to the redpient, nd benefit to the 
community, eqoal, I have no doabt, to all that ooold he poenbly obtained 
by a new line of Atlantic ateamen, though ever eo anoeenful. 

This sulriect has two points of coneideratien of especial tbIuc with 
regard to tike tmqtenmce refcmoHan. An improyement in the condi- 
tion of the home of the Idborer, will remoTC one of the temptations to 
his frequent yisits to the more comfortable and inviting grog shops, 
while the substitution of a more invigoratinff and stiinulatin|g atn^Miphere, 
will relieve in a considerable degree, the &siie for artificud stimulus* 

AQnospfaencair is to-the anioM ii s yst em, a powerful stimulant as well 
as nutrient substance. In sufficient puri^ and copiousness, it imparts 
a sustaining and vivifying power uniMiualled by any other substance. 
Its vitalizing operations^present one instance of the wonderful adaptap- 
tions of natimd things to each oth^, but it is singularly striking, because 
of the immediate and incessant dependence of animius upon it, for life 
and strength. Air, when pure, n^^ ^ freshness and vigor, a tone to 
the nervous and muscular parts cf the system, productive of the highe»i 
degree of mental and physical enjoyment. • Without the tone thus im- 
parted, the functions of the system become relaxed, and in addition, the 
animal spirits and feelings become depressed and uneasy. To relieve 
this condition, nature instinctively seeks some ^ stimulating means. 
Many feed on mentsl excitement — ^the stimulus of business with some, 
with others <£ society, with some dT hope and expectation, keep alive 
the energies. But the fermer feeds his nervous and general strength 
on fresh air and wholesome labor. Artificial stimulus is not required 
by him, he does not feel its want, and has comparatively little relish for 
it. But the dwellers in tiM cellars, courts, and ill-ventilated garrets, 
depressed and prostrated by the want of the stimulus given by nature, 
unable to enjoy the feelines guaranteed by an unfeiling abundance of 
oxygen, instinctively feel Uie want of a substitute ; they Jmd ii in alco^ 
hoL The allurements held out by those dens of destruction, abounding 
on all sides, add temptation > to instinct, and the child of ignorance and 
misfortune terminates his senses, and often his life, the victim of licen- 
tiousness and unnatural debauchery. 

First take the drunkard from the cellar, give him the stimulus of a 
pure atmosphere, relieve the demands of nature in this particular, and 
the work of reformation is half done, and will then go on with increased 
vigor ; but as long as he is deprived of the sustaining power offered by 
nature, his artificial appetite will be less easily appeased. 

The community is guilty of the double ofience of cutting off from the 
destitute part of its members a propel supply of air, in omer words, of 
exciting an appetite for a vile and destructive substitute, and then of 
presenting to them at almost every corner, opportunities for indulgence 
in the poison. 

Very few members of the medical profession ever find a seat in the 
public council chamber. Legislative and executive bodies must, there-' 
fore, be dependent, in their ignorance of the subject, upon the know- 
ledge and experience of the lay members of the profession, to enable them 
to make the proper laws, and exercise the proper authority for the pro- 



teetioQ of their eonstitueiiti agaioBt the encroachments of disease. Is 
it not then, clearly the duty of the appointing powers, to fill the offices 
having the control and direction of sanitary matters, with men of the 
largest experience and most cultivated capacity in medical science, 
having regard to the important consideration that a man may be a good 
prescribing physician, without the kind of knowledge or the taste re- 
quisite for the due discharge of public duties of this character. This 
is a peculiar knranch of the science, (though strictly medical,) and as 
distinct as the practice of surgery. 

The judgment which should be exercised in seeking medical advisers 
for ourselves or Qur families, is equally, if not more imperative, when 
the protection of the 300,000 members of the community is concerned. 

The necessity for a medical education in an Officer of Health, may 
be shown by instancing some of the practical duties which must be per- 
formed by him, whether a chief or subordinate. The question '^ what con- 
stitutes a nuisance ?" is one which now divides the scientific world. On 
either side are ranged the most acute and philosophic minds. Experi- 
ment upon experiment has been tried, the light of science and research 
has been profusely expended, in the endeavor finally and satisfactorily 
to settle this question, so important to the health and happiness of 
man. On the one hand, the public health is to be protected at what- 
ever cost, and on the other, private property must not unnecessarily be 
destroyed. Can it be supposed that a decision of this frequently intri- 
cate question by an officer who has little or no knowledge of chemis- 
try, nor physiology, nor the laws of miasma, nor any other science 
bearing on it, will be satisfactory to the public, or to the holder of the 
property destroyed by his order ? And is it reasonable to suppose that 
in such hands the public weal can be secure against the influence of 
disease — generating nuisances ? Such an officer should always be able to 
assign the most conclusive and satisfactory reasons for his acts. The 
severest acumen, and most rigid search, are frequently, for a time, at 
fisult in detecting the source of a wide*spreading pestilence — this city 
has repeatedly been visited by endemic diseases, and has greatly suf- 
fered in reputation and interest in consequence of a want of energetic 
and capable o&cen early to detect and remove the latent cause of the 
disorder ; and where learning and experience have sometimes been 
baffled in the discovery, or right estimate, of the sources of general 
sickness, it is folly to suppose that ignorance and inexperience, 
though associated with morsl worth, can infuse confidence in the com- 
munity, or give to it safety or credit. 

The nature of the products of decomposition must, therefore, be 
thoroughly understood, before a correct conclusion can be arrived at, 
for upon them it depends, whether the decaying matters are capable of 

Generating disease in the human firame. And here we find the nicest 
istinctions necessary. For example, putrefying vegetable matter, in 
general, is believed to be a prolific source of disease, but there is a 
wide difference between different vegetables ; some are almost innocu- 
ous, while others are exceedingly baneful. Some, while decaying, 
give forth gases of the most o&naive and deleterious character, ami 


from otben in the like stete, little will be obeenred. The difirence 
between <^ decay*'^ and ^ potie&etionf " the two deetroying proceiaee 
which animal and vegetable matten undergo^ and whidi are wide aaun* 
der in their native and eActa, ahonld be well undentood and nevec 

The following communication from mr friend and cc^leaguei Dr. R. 
K. Hoffinan, exhibits in a striking light the Tiffilanee and discrimi- 
nation necessary on the part of those who have Sob care of the health 
of large nutobera of persons. 

FhmB, JT. Hbffmm, M. D., laU amrg^m U» A Na99. 

.82 Warren Stieet, Augnit dQth, 1844. 

Mt dear sir,— Yoor note of the d6th inst. reminds me of oar con- 
yersation at the Hospital, in which I mentioned the occurrence of fever 
on ship board, from the decomposition of Testable matter. 

On referring to my Journal for the particulars you ask for, I find 
other causes combined, which alone may be considered sufSicient to have 
originated and propagated the fever ; but I will state the circumstances 
from which you will make your own deductions. 

In the summer cf 1817, Uie U. S. sloop of war Ontario, com- 
manded by Capt. James Biddle, was fitted out in this port for a voyage 
to the Pacific Ocean. On the 24th of June, she left the Navy Yard 
and anchored in the North River, off the Battery. The crew, consist- 
ing of 175, continued for a time as healthy as ustiai far a new crew m 

Being destined to convey Mr. Rodney and Judge Frevost, as Com- 
missioners to Buenos Ayres and Chili, a large supply of cabin stores, 
including the ordinary vegetables, was received on board, and stowed 
in rooms constructed for the purpose, on the berth deck, between the 
hatchways, obstructing ventilation, and encroaching on the space 
allotted to the men to sleep, while that under the top gallant forecastle 
was redolent of its new occupants — poultry and pigs. The season 
was rainy, sultry, and damp ; and the state of the weather compelled 
the crew to sleep below, where the exhalations from decaying vegeta- 
bles, especially in a calm night, rendered the air almost insufferably 
hot, and peculiarly offensive. 

Such was the condition of the ship, when at the latter part of July, 
during the calm, sultry, rainy weather, a sudden increase of disease 
took place ; it commenced with a sense of great debility, particularly 
of the limbs, aversion to all exertion, pains in the head, loins, and 
bones, anxiety and nausea — the skin generally moist and hot, tongue 
loaded wilh a yellow coat, bowels rather loose. In some it assumed 
a Typhoid character in its progress, while its more ordinary type 
was that of bilious remittent. There was a daily succession of cases, 
and from the 20th of July to the 15th of August, the average number 
was thirty. 

Captain Biddle did not concur in opinion, with the surgeon, that lo- 
cal causes had the principal agency in producing, the disease, but seeing 
no prospect of realizing the expectation of getting to sea, obtained from 


Colonel Haidman, the commandiiig ofSicer, a spacious and airy building 
on the south side of Governor's Island, to which at the date above men- 
tioned) the sick were removed. On the 17th there were three new 
cases ; on the 18th, two ; on the 19th, none ; on the 20th, two ; on 
that evening the wind came from the north, the air was cool, and three 
more sickened, preceded by a chill. These cases were transferred in 
succession to the hospital on the Island. With the change in the wea- 
ther, which continued comfortably cool, with fresh breezes, the fever 
gradually disappeared, no new cases occurring after the 24th. 

I would add that in the course of the voyage, when all on board were 
healthy, the first Lieutenant, who occupied the forward state room, 
sickened with symptoms of fever. On searching for the cause, some 
rotten potatoes were found in a locker adjoining his room, firom which it 
was separated only by a board partition. 

The state of health in the city was good during that season. 
None of the men died. I am, sir, yours truly, 

Richard K. Hoffman. 

The subject of sewerage is destined to be one, which of necessity must 
ere lone occupy the attention of the people and the government, and 
upon which an intelligent and judicious officer of health may throw much 
light. It will, I am satisfied, be found not only the most economical, but 
the only mode, in which the immense mass of filth daily generated in this 
large city, can be effectually removed. In some foreign cities, under- 
ground sewerage on a regular uniform plan throughout, the sewers con- 
structed on the most scientific and substantial plans, has been carried 
out in the completest manner, with the most decidedly beneficial results 
upon the general health and comfort. We are annually giving proofe 
of our belief in their necessity, by the construction of single sewers in 
various places, as they are demanded by circumstances, but it is done 
without reference to any uniform plan, and it is feared that thus much 
eonfusion and great additional expense, will fall upon the treasury when 
ever it shall be deemed proper to project and carry out over the whole 
city a complete and uniform system ; and I believe, '' to this complex- 
ion must we come at last." One thing especially brings this conviction ; 
since the introduction of the Croton, the rain water cisterns being use* 
less, the bottoms of them have in many instances been taken out, and 
they have been converted into cispools, into which the refuse matter of 
the houses is thrown. Great trouble is thus saved to fitmiiies and do- 
mestics, but it needs no prophetic vision to perceive, that an immense 
mass of offensive material, will thus be soon collected, its decomposi- 
tion polluting the air, in the immediate precincts of our chambers and 
fitting rooms, and generating an amount of miasmatic efiluvia, incalcu-r 
lably great and injurious. Discharge all the contents of our sinks and 
cispools, through sewers into the riv«rs, and we will avoid two of the 
most powerful causes of sickness and early death. 

The great quantity of water from the sky, the hydrants , the un- 
used wells, &c., now accumulating beneath the surface, must 
MxA its way into ta»ny basements sind 4:eUiuni, rendering tbena 


vefydtmp and unhealthy, and finr which sewen eoDstitate the only 

Another mooted stnitary qoettion, k the influence of grmoe^ardi^ 
vauUs^ and other barial-plaoes, in lai^ cities, upon the health of the 
inhabitants. Some acute men are now endeavoring to maintain that 
no specific bad results have ever been, or can be, justly attributed to 
them, while others, among whom is Chadwick, regard them as highly 
objectionable, and on this side appears the most direct and positive evi- 
dence. In ^is city are some places (^ interment, whicli, whatever 
BEiay be said of their effects on health, are certainly crowded and offin- 
sive to a high degree ; their condition and influence, as certainly, de- 
mand an intelligent and careM investigation. 

WkUe writing tki$ commumcaHon^ there applied to me for medical ad- 
vice, a young man, who had gone, in good health, into a vault of a 
church in a densely populated part of the city, to see the coffin contun- 
ing the remains of a relative; he had been in but a few moments when 
the effluvia was so offensive and powerful, as almost entirely to over- 
come him. He immediately retired, returned home, and when I saw 
him, three hours after, he was laboring under a considerable degree of 
fever, and other disordered symptoms, which he said had all come on 
since his visit to the vault. He thinks the vault must have contained 
not less than 200 bodies. The place has before been complained of, and it 
is difficult to avoid the beli^ that more or less injury must be in^ted 
by it on the health of the neighborhood. 

Not the least important of the results which should be obtained from 
the appointment of an ofBcer to supmntend the affairs of public health, 
is that of keeping a constant watch upon the progress of diseases, draw- 
ing the proper inferences obtainable from a careful inspection of the 
mortality returns, and giving them to the public in a suitable form and 
manner. Living as we are in constant subjection to attacks of bodily 
disease, induced by the circumstances of life, the lances of death held 
constantly ^' in rest," by a thousand unseen hands, waiting only the 
stirring of the breeze to thrust them at our unconscious frames, such an 
officer should be as a sentinel upon the tower, watching with an intel- 
ligent and never closing eye, the manoeuvres of the wily enemy, and 
with a ready pen, alert to send the alarm to every quarter, and 
prepare the city for a defence against his approaches. The inhabitants 
may be, some, reckless of danger, and careless of life, others may affect to 
despise the warnings of the watchman, and scoff at the '^ Philosophy of 
Diseases," but it is no less the duty of the faithful magistrate and officer, 
to see that at all points the constituency are guarded, with whatever 
of science and virtue they can find. 

There is in this city but one officer in the receipt of the certificates of 
death — the only source of knowledge of the diseases which prevail. 
He is the City Inspector. It is by law made his duty to publish every 
Tuesday, a list of the deaths occurring during the preceding week, and 
in January, '' to publish the whole number of deaths which shall have 
occurred in the city of New York during the preceding year, with the 
sexes, ages and diseases of the persons so dying." This is the kiter of 


the law, and any boy, who has the quantum sufficU of reading, writing, 
and arithmetic, with a fair proportion of patience, may make oat the 
tables in the unscientifically alphabetical mode in which it has usually 
been done. But of what use is this ? we learn by it that 9,000 or 10,000 
deaths, occur annually ; we are informed of the diseases which cause 
the deaths J (if the arangement is worthy of dependence, which it is not 
always,) but of the causes of the diseases we are told nothing. To de- 
rive the proper and full advantage from the returns of mortality, we 
must look beyond the mere name of the diseases, and ascertain the sources 
of those diseases* Now I the reports are useful for little more than to 
satisfy ordinary curiosity, or to enable the preacher '< to point a moral *' 
— but if properly analyzed, and their whole bearing and influence ex- 
posed and elucidated, they would become valuable aids to the private 
physician, and to the public officer of health, in studying the liabilities of 
New York, and the influences of its climate, position, temperature, and 
other circumstances in producing diseases. 

If I may be idlowed to illustrate this point, by referring to a result of 
my own study of some of the Annual Reports, 1 will recall attention to 
'the discovery, that in this city there is less consumption among the na- 
tive residents, than in Boston or Philadelphia. This is proved by a cal- 
culation, the corectness of which may be tried at any time, which 
has not yet been questioned, and which turns the tables completely, 
as they were before set down, by those who would make New York a 
comparative Golgotha. 

This officer should study the influences of seasons, localities, and 
many other circumstances, on the aspects of disease, and he should keep 
a record of the Barometric, Tbermometric, Hygrometric, and Pluvial 
changes. An improvement in the certificate d death, is also much 
needed ; a more clear designation of medical terms, inquiries into the 
condition and physical circumstances of the decedent, the length of his 
residence in this country, if a foreigner, and the influence of the change of 
climate upon the cause of death, and many other points, are necessary 
to obtain correct and specific conclusions, respecting the diseases of New 
York ; while a thorough knowledge of the wants of science, and of what 
has been done abroad, in countries where the subject has constituted the 
labor of the lives of the most gifted individuals, is highly desirable. 
All this knowledge can only be obtained, and the improvements properly 
urged and applied, by an individual of good medicsd education, and one 
who has a taste, and willingness for the work. A capable Health Offi- 
cer would be well employed, and it should be made his interest, to de- 
vote hts time and talents to the dissemination of sound precepts con- 
cerDiMs; the preservation of health and life, among the people, to whom 
knowied^ on these subjects is now almost inaccessible. To a vast 
number, tor whom instruction as to the best method of regulating their 
internal and external domiciliary, and their personal arrangements, is 
most desirable, it could be given in such forms as would certainly arrest 
attention and be productive of incalculable benefits. The circumstanced 
of life, which have influence in producing disease, are endless in nura- 
tter^aad yet tbe suflfeien^) in too many instances^ are wholly ignorant of 


their power, or eTen of their exitteoee. This it true to a |re«t extent 
of the rich and edocatedy as every physician knows, but it is emphati-* 
cally the case with the destitote and ignorant, to whom the laws of 
health and life, are a sealed boois. 

These labors I regard as answering to the sptril of the law, and, in 
ne«rly the words of an able writer on poverty and crime, ^ The wisest 
ciyil regulations that can be derised, will avail but little for the ad* 
Tancement of society, if the oflScers who execute them, look not beyond 
the letter of their commissions, and fiui to communicate what they 
learn of the causes, the remedy, and the prevention of diseases.'* 

To this subject the language of an inspired penman may be literally 
applied ; — ^*' the letter kiileth, bnt the spirit" 

A sanitary police, composed of such individuals as are herein sunest- 
ed, would constitute an efficient corps of Healih Jftsnomines. Theur 
time would be principally devoted to the purpose of teaching the poor 
the rules which should regulate their housenold operations ; and the 
value of fresh air, ventilation, cleanliness, temperance, te., would form 
constant themes for them. The circuhition of Tracts on Health, dis* 
tributed with the same freedom as religious tracts now are, by hands 
equally interested in the comforts and condition of the poor, would form 
a powerful addition to their means of usefulness. The Dispensary Phy* 
sician wields for these purposes, a power possessed by no other class of 

To the habits of life of many of the laboring classes, to their confined 
ment in small apartments, and to fiketr iynoramce ^ ih/t too* of hfe and\ 
heakhy by which especially, even their contracted arrangements are un*: 
necessarily kept in a bad condition, we are to look for no incobsiderable. 
amount of the injury which they sustain. The moisture, filth, and 
confined atmosphere of the courts and alleys, are also prolific 
sources of disease ; in the occupations of many lurks the enemy. But 
if we restrict our attention to them, we shall overlook a very large pro- 
portion of the causes of mortality, and with all our efforts to improve 
the sanitary condition of our city, we should &ii in some of the most 
essential points. A well regulated and efficient Health Police might 
do much towards correcting the existing evils, but to carry the desired 
reform to the utmost limit, and with a greater permanency, measures 
which no police can carry out, are necessary. And as these evils are 
not confined to the laboring and destitute part of our population, but 
afflict also the wealthier portion, a more healthy state of public opinion 
is absolutely necessary, to effect the desired results. 

This can beaty if not onhjy be done^ by making Physiology y as appHed 
to the laws of Hfey and the prevention of diseasesy a subject of study in 
all our private, publicy and common schools. The children who attend 
these, especially the latter, are the individuals by and with whom, the 
important change of opinion and habit, is to be wrought, if at all. Jt is 
needless to say to an ignorant adult, apparently free from sickness, that 
he lives, works and sleeps, in too confined an atmosphere — he will an- 
swer that he is well enough, a change would be irksome, and cost money, 
and he will not believe what you say, for he cannot be easily made to 


understand the importance, or even the right use, of air. Bat bring up 
his child in a knowledge of the value and necessity of pure fresh air, by 
teaching him the relations which it bears to the blood, the digestion and 
other functions — teach him never to fear it, that it is his immediate and 
incessant source of life and health, give him a knowledge of the disea- 
ses and dangers to which its absence will subject him, and think you 
he would not avoid its impurities, as he would poison or the pestilence ? 
In his school-room, his sitting-room, his chamber or his work-shop, he 
would seek for a pure clear atmosphere, as when thirsty he would seek 
the cool water, as the weary " hart panteth after the water brook." 
<' Ventilate, Ventilate," would be his natural demand, in tones of earn- 
estness proportioned to the necessity which his expansive lungs, and 
ever freshened feelings, would readily discover. The humble tenement 
of the laborer, would then, though but a single room, be no longer shut 
night and day, unvisited by the refreshing air of heaven ; the work- 
shop would then no longer be a close receptacle of foul effluvia of hu- 
man and other origin, and our churches, public rooms, and lecture halls, 
be no more unventilated. (En passant^ what a strange inconsistency 
is it, in the refined and polished, to object to sip a mouthful of water 
from the same glass as an other, in which there could be no possible 
contamination, and yet swallow over and over again, the breath of 
others shut up in the same apartment, and which has passed through 
Jiundreds of lungs, perhaps diseased, and over teeth in every stage of 

So with their food and drink, their exercise, personal cleanliness, 
and all other things pertainine to health and longevity ; when once in- 
structed in the principles which should be observed with regard to 
them, how great would be the difference in the habits of life. If it 
is admitted that many of the improprieties of life are due to an igno- 
rance of its laws, then a knowledge of those laws would cause a dimi- 
nution of the improprieties. 

And I submit, whether a more powerful aid of temperance can be 
found, than instilling into the youthful mind a knowledge of the struc- 
ture and functions of his system, and the poisonous results of alcohol 
upon them. 

The general introduction of this subject as a branch of school learn- 
ing, would, I hesitate not to say, have a greater meliorating influence 
upon the human condition, than any other. Already has it been intro- 
duced into many private schools, and given delight to both teachers 
and pupils. The abundance of material, and the facilities for its illus- 
tration, put it on a par with Chemistry and Natural Philosophy, in at- 
tractive interest, while for real usefulness to the concerns of life, it is 
far in advance of Astronomy, and many other studies, now generally 
taught, and for which it might be advantageously substituted, should 
any change be necessary. The operations of a living machine must 
necessarily possess a degree of interest to the student and observer be- 
yond those of inanimate bodies, and when once the study of the animal 
madme is divested of its ancient and unnatural feelings of supersti-* 


tion, and of its exdosiye and nnnecessaiy confinement to the physi- 
cian, (which I think are rapidly disappearing,) it will be found to yield 
a degree of entertainment, as well as usefnlness, onsorpassed. 

Now where are the advantages of this study most needed ? amonff 
what classes of the community are its precepts and laws, its vital and 
saving influences, its checks and guards against disease and danger, 
most required ? Is it among those who live in high-ceiled rooms, who 
have plenty of time and means to so abroad and sedc fresh air in the 
country, who can afford to live on ue choicest delicacies, and dress in 
the moist comfortable manner, who have no fear of want, and are not 
compelled to study the most economical mode of living ? or to seek 
out, from a very limited field, the best they can do for themselves ? 
No ! indeed, such need comparatively little aid. They may turn nieht 
into day, and dissipate their time and strength in debauchery and fouy, 
but they are not compelled to reside in cellars, and chambers ill venti- 
tilated, or to associate with filth, in foul air. They are to be reached 
only by moral teaching. But those whom penury subjects to the ne- 
cessity of livine in the cheapest rooms, who must submit to the hardest 
extortions, or live in the street, and whose gross ignorance prevents 
them improving their condition as much as they might, haa they a 
knowledge of the true mode — these constitute a large class for whom 
humanity demands that we should employ every means in our power 
for bettering their physical, as well as their moral, condition. Of what 
use is science, if it cannot be applied to the practical purposes of life, 
or employed to improve the character and condition of our fellow crea- 
tures. It can no longer be shut up in monkish cells, nor yet will I be- 
lieve that its absence in an Officer of Health, will, by the community, 
be regarded as a qualification for office. 

These pages have become extended to a number entirely unexpected 
at the commencement, yet no allusion has been made to many matters 
of sanitary value, which cannot be omitted in the consideration of the 
general subject, without leaving it in a state of incompleteness. The 
present condition and wished for improvement of the destitute part of our 
population, have been my specific objects of attention. An extract 
from the latest (English) work upon the subject of ventilation, recently 
put into my hands, places this whole subject in its true light. ^< The 
^' dwellings of the extremely poor present scenes of misery, desolation, 
'' and woe, which it is afflicting to witness, where the sensibilities are 
'^ not hardened against the sufferings of humanity. They must be seen 
^' to be. understood, and to draw out that amount of individuals sympa- 
'^ thy, which they imperiously demand, in a civilized and christian com- 
'^ munity. The station of this country in arts, literature, and science, 
^' is acknowledged throughout the globe, as well as its naval, military 
^^ and commercial power ; and, latterly, its exertions against the slave- 
'< trade, have given a noble example in the cause of humanity, and 
'^ soften the recollections of former times. But the regeneration of its 
<^ own population, or rather the placing of them in that condition which 
<^ the progress of religion and philanthropy demands, is perhaps a task 


<< of more moral grandeur, and of still more difficult execution than 
^' any which it has attempted." 

To this I will only add, in conclusion, (what has heen hefore hrielly 
referred to,) that respecting the Laws of Health and Life, it may be 
said, though the remark may seem so extraordinary as apparently to 
amount to a libel on human nature, on no other subject connected with 
the interests, happiness, or longevity of man, is the darkness of igno* 
ranee so profound and so universal. 



I'itliit of Saititerj |itkiii, 





§im of Smht^ '^tbim, 


NOVEMBER 14th, 1S6I, 

By JOHN H. GRISCOM, m.d., 

FrlDlcd hr OiAoT mt Ihe AaaaeliillaB. 




Mr. President, and Members of the New York Sanitary Aitoeiaiiov ; 

The period is again approaching wlien it behooves the 
friends of Sanitary Reform — a phrase Bynonymous witli 
saving the lives of the people — to be about the noble work 
which they have set out to accomplish. Though seven times 
defeated in their efforts to stay the progress of disease and 
death, their hearts fail not, nor is their determination 
abated. Nor though seventy times seven should the ene- 
mies of this holy cause succeed, by bribery and corruption, 
in postponing the day for the inauguration of the most 
valuable of all the reforms known amongst men, will its 
votaries lay aside their amior, or cease to contend for the 
faith which animates them with the assurance of final suc- 

Though, like the disciples of Him who went about heal- 
ing all manner of disease, and unlike them who have thus 
far betrayed the people to their destruction, they carry 
neither purse nor scrip, the friends of Sanitary Reform in 
this city will never cease to show the public their true in- 
terests in this matter, and demand of their legislators the 
abolition of the official nuisances which are the only 
obstacles to the removal of those physical nuisances, under 
whose foul influences so many thousands find untimely 

One of the most surprising phenomena in the political 
economy of this state and city, ia the indifference of the 

|ieoplc to their own death records. They either refuse to 
listen to, or, if they hear, they heed not, the facts concern- 
ing the dealings of death among themselves. There is no 
denial that the mortality of this city ih much greater than 
that of many others of far inferior advantages for salubrity 
and longevity, and yet the trump of the archangel sounds 
in their ears in vain. Their well-cushioned officials drain 
them of their fat salaries, but do literally nothing in return 
to raise the standard of health, or check the march of pes- 
tilence. Their legislators listen year after year to th« 
appeals in behalf of the thotisunds of dying infanta, and 
when apparently moved to comply with the urgent cri,- 
for relief from the threateningg of disease and death, the 
demon of bribery drops a golden curtain between them 
and the pictures of desolate misery which have so moved 
them, and suddenly all assumes a rose color, and thence- 
forth, while their pockets are filled with sinful wealth, 
the cemeteries of the metropolis become populated in an 
iucreased ratio. 


Lest any one should regard this as too strong language, 
let me present the facts upon which it is based : 

In 1859, a Health Bill, which would have been the 
means of saving thousands of lives in this city, passed the 
State Senate, almost unanimously, and went down to the 
Assembly, where there was every indication that it would 
soon become a law. It passed readily through all the pre- 
liminary stages of legislation, until it reached its third 
reading, when, on his name being called, a member from 
this city, who had been its avowed friend, and its acknowl- 

edged and accredited advocate before the House, and who 
had pledged himself, in the face of the Assembly, to the 
honorable fulfillment of the trust which the friends of the 
bill had reposed in him — that member rose in his place, 
and declmed to vote, but said if his vote became necessary 
1,0 carnj the bill, he would, in that case, vote in the affirma- 
tive — an alternative which he himself could have rendered 
unnecessary. The withdrawal of his vote and influence, 
at this juncture, kiUed the hill, and as a consequence, de- 
stroyed the livea of we know not how many of hia con- 
stituents, and all, as he himself afterward declared, because 
by the success of the very measure oi' which he himself was 
the putative father, three of his friends would be legislated 
out of office — offices which, of course, they were incom- 
petent to fill. 

Dismayed, but not disheartened, by this treachery, just- 
ice to the betrayed and down-trodden poor, and the claims 
of Sanitary Science, demanded a renewal of the effiirts the 
next year. Accordingly the Legislature was approached 
with a bill, with details improved by experience and a 
better knowledge of the health laws of other cities, both 
foreign and domestic. It was presented favorably to the 
Assembly by the appropriate Standing Committee, with 
an elaborate report,* fully setting forth its merits, and the 
urgent necessity of the measure. It was, in fact, a meas- 
ure of life or death to thousands of both city and State. 

But, alas ! its friends reckoned again without a sufficient 
knowledge of the character of many of our law-makers. 
It was the year of gridiron railroad scheming, and Sus- 

c]Tie1iann8 bontisaa ; and again the office-holders of tHs 
city, one of whom, from the City Inspector's Department 
itself, was a member of Assembly, so wrought upon the 
fears and pot;ket8 of the friends of those measures, that the 
Health Bill was again defeated, even two of the signers 
of the report voting against it. 

The crying of the helpless, nevertheless, censed not 
to fill our cars, and the demands of Science, so far from 
'yielding to these base betrayals of her rights, grew 
louder and stronger. The subject was again presented 
to the Legislature of the present year, and from the char- 
acter of many members of the Assembly, there was every 
prospect that in that branch it would meet with suecess, 
with a reasonable hope in the upper house. The vast im- 
portance of the measure was appreciated by a majority of 
the assemblymen, in all its fullness, and though opposed, 
both covertly with money, and openly by speeches, it pass- 
ed that body by a vote of exactly two to one. But the 
seats of the senate chamber were occupied by tlie same 
individuals us in the year before, and though there were, 
among them, many above reproach or suspicion, to a too 
large number the last chance had come for a pecuniary 
addition to the unholy gains of legislation. 

It is averied that about S30,000 was raised in this city, 
anmng the office-holders, and expended to defimt the Health 
Bill of last winter. To the exactness of this statement, we 
cannot, of course, affirm, hut this we do know: thatontlie 
Saturday previous to the Wednesday of adjournment, the 
vote for a third reading stood 19 to 19, while just on the 
eve of adjournment, when the bill was put upon its pas- 
sage, the hopes of a suffering community were dashed to 

the ground by a reversal of this vote, and some thou- 
annds of new-naade graves stand as monuments of the wick- 
edness of men whose names are known as partakers of 
those thirty pieces — the price of innocent blood.* Then 
it was that the enemies of the people's dearest interests 
triumphed ; thus have their selfishness and wickedness stood 
against the demands of humanity, and opposed the pro- 
gress of scientific reform. 

The recent revelations of a famous libel suit but dimly 
shadow forth proceedings similar to those attendant upon 
the defeat of the Health Bill of last winter, the realities of 
which are well known. 

The dying eagle saw on the arrow whose barb had 
pierced its vitals, feathers plucked from its own wing ; so, 
tlirough the salaries of its officials, the tax-payers of tliis 
city supplied the motive power of the machinery which 
did this death-dealing work among themselves. 

Thus were we furnished with another proof that 


Let me now attempt, with as much brevity as is com- 
patible with so serious a subject, to show something of 
what this city has suffered from these cori'uptions, and 

• The New York Vaay TrOum 
D Monday, AprU 15, ISfil : 

" Wa iinderatani! that 110,000, ii 
n Friday night, to ilefeut the Ueti 

I of Street titveepiDs. We ehould haie to hure 

what it might have gained, had our legislators and olBcc- 
holdera all been actuated by honest motives. 

There are certain diaeaaoa whjfli infest cities, almost ex- 
clusively — and to the greatest extent those which are mort 
crowded, and filthy, and the least ventilated. They have 
impurity for their father and privation for their mother. 

There is another class of diseases which, though not pe- 
culiar to cities, are vastly more prevalent and destructive 
in localities where the laws of hygiene are neglected — 
where the broom, the whitewash brush, and the Health 
Warden, are equally strangers, but which are ehorn of 
half their influence where cleanliness and pure air are thi* 

There is yet a third class, which are always and abso- 
lutely preventable, anywhere and everywhere. 

To the fii-st class mentioned belong Cholera, Cholera 
Infantum, Typhus and Typhoid Fevers, and some others. 

In the second class are comprised Scarlatina, Measles, 
Whooping-cough, Diarrhosa, Dysentery, Croup, Erj'sipclas. 
Puerperal and some other forms of fever, Infantile Con- 
vulsions, Hydrocephalus, Marasmus, and some others. 

In the last, or wholly preventable class, are included 
kSmalt Pox and Intermittent Fever. 

During the last 22 years, there have died in this city. 
of the first class I have mentioned — 

Of Cholera Infantum 19,346 

Of Typhus and Typlioid Fevers 10,108 

Total 29,454 

But see what an astoDisbing progress the first of these 
has made. Id the three years, 1810, 1S17, 1818, there 
died of Cholera lofantum, 81. In the year 1860, there 
died of it, 1,664. The ratio of increase of this mortality, 
compared with the increase of population, was as 20 to G. 

By the second class of diseases, those by which our 
mortality is greatly increased by vicious city couditions, 
the losses were as follows : 

Scarlatina 12,351 

Measles 4,630 

Whooping-cough 4,351 

Croup 8,513 

Diarrhoea 9,650 

Dysentery 10,800 

Erysipelas 2,770 

Puerperal Fever 2,523 

Convulsions 28,251 

Hydrocephalus 15,739 

Marasmus 21,880 

Total 121,476 

Here is an aggregate mortality of over 150,000, of which 
I believe that, under the beat possible hygienic conditions 
in which this city might have been put, one-half might 
have been prevented. It is at least safe to say that one- 
third of this mortality was due to the vicious modes of life 
of the families among whom it occurred. Here, then, ia a 
population of 40,000 actually lost within the period of one 
generation, which, under propermanagement by the public 
officers of health, might now have swelled the already 
proud supremacy of this metropolis. 

I have omitted from this enumeration the deaths by coh- 


natation — ^whicb disease, though due in a great meoBure to 
external circumstances of life, is oftentimes tlie oSspring 
of hereditary taint. By that disorder there fell, in the 
23 years, nearly 50,000 victims, a large number of whom 
might, doubtless, have been saved by proper sanitary treat- 

These diseases, taken collectively, constitute the sanitary 
index of their locality. They are the hygiCHic barometer, 
whose figures on the scale denote the state of physical 
health, derived from the modes of life, the character of the 
dwellings, the condition of the streets, the attention given 
to the removal of filth, the extent and perfection of the 
sewerage, and the degree of intelligence and supervision of 
the health officers. The higher the figures, the more do- 
graded are the people in all those circumstances. 


I have said that the mortality from the diseases of these 
first two classes here enumerated, is the index of the 
hygienic condition of the people, and of the care extended 
over them by their sanitary officers. Judged by that 
standard, we find the metropolis of the western hemi- 
sphere at a lower grade than any other known Christian 
city of equal size. 

But what shall we say of it, when our attention is 
turned to the diseases of the third class, which are derived 
from causes absolutely, and at all times, preventable, and 
from which there is no need of a single death in a century, 
hut from one of which alone, and that the most easily 
prevented of all, we have to enumerate the loss, duiing 

the past half-century, of nearly 11,000 lives — every one 
of which could, and should, have been preserved? 

The average number of deaths by Small-pox for the 
past ten years, iu this city, was 406. The present year 
has already exceeded that by about half a hundred, and at 
the rate of the past nine months, the whole mortality at 
the end of the year, will have been at least COO. When 
we further consider the facts respecting the control of this 
disease in some of our sister cities, from which, during 
the past two or three years, it has been eradicated by 
the well-directed energy of their Boards of Medical Health 
Wardens, the contrast of our degraded and depraved con- 
dition is shocking indeed ; and in view of the other fact 
already adverted to, of the defeat of the Health Bill in 
the Legislature, by the wicked maehinations of those 
ofhciuls who should have been the first, as they are the 
only ones whose duty it is, to apply the great preventive, 
we hold them, and those above them who participated 
in producing the disastrous result — we hold them indi- 
vidually responsible for the loss of these lives. A fearful 
retribution awaits them for this mortality by Small-pox 
at least, to say nothing of that larger number by other 
causes, which, but for them, would have been prevented. 


In general estimation, probably, there could exist no 
more inauspicious period for the prosecution of works 
of benevolence and reform, than during the excitement of 
a general war. The clang of arms, the hurrying to and 
fro of armed men, and especially the profound excitement 

and apprehension of dire eviU which, like a. heavy clo 
eovolop the minds of men, are apt to blind them to all I 
else than the immediate preservation of their homes and | 

Nevertheless, there are considerations independent of the 
preservation of our families from immediate attacks of J 
sickness; and an examination of this Sanitary question, in 
connection with its bearings upon the present state of the | 
country, will be found instructive. 

It is now nearly twenty years since the practice was i 
instituted in this city, of putting the great iutereata of the ' 
Public Health in charge of party ]>oliticiBns, ignorant of I 
the causes of diseases, or the means of their prevention. 
Since that period the ratio of mortality to the population ' 
lias been rapidly on the increase, while the expenses of the 
departments have even more largely augmented. In this I 
respect the city of New York has pursued a course directly I 
the reverse of that of almost every other large city. Before 
the light of Sanitary Science had become generally diffused — ' 
before it had reached above the masses, and had thrown 
its illuminating rays upon the government above them — in 
almost every other city the custom prevailed, which now i 
obtains here, of confiding the Sanitary duties to Lauds un- I 
educated in the laws and circumstances which govern the ' 

' production of diseases among masses of people. Formerly I 
all diseases were attributed to providential visitations, to 
meteoric influences, or other occult causes, over which man 
liad no control, and the duties of the physician pertained 
solely to the curing of distempers which were thus mysteri- 
ously produced. Even aa far down in the age of the 

. civilized world as the time of Elizabeth, when the jail I 



fever broke its prison bounds at the asBizeB, and swept 
prisoners, spectators, juries, and judges into simultaneous 
graves, the sources of this and other serious distempers, 
now 80 perfectly known, were undreamed of, and physi- 
cians had no part or lot in their prevention. Even when, 
a century later, in 16C5, the plague and other diseases 
swept away in one year nearly 100,000 of the inhabit- 
ants of London, the idea of a public Sanitary reform 
seemed scarcely to have entered into the minds of either 
people or government ; but in the following year, the great 
conflagration of that city, which laid 43G acres of houses 
in ashes, burned into them the idea that by wider 
streets, more spacious tenements, above-ground dwell- 
ings, and other means, the reappearance of the terrible 
epidemic might be avoided. It was then that the science 
of preventive medicine began to be understood, to which 
the great Sydenham gave a powerful impulse — whereunto 
the heroic Mary Woetley Montague triumphantly as- 
sisted, by the practice of innoculation, — and the immortal 
Jenner gave the finishing touch, by his grand discovery 
of vaccination. 

From that period, the commencement of the present 
century, the march of Sanitary Science has been rapidly 
onward, until into every comer of the civilized globe, with 
one exception, its benignant healing and preservative rays 
have been allowed free access. 

But one darli spot remains, its gloom enhanced by its 
contrast with former days — for, as I have already stated, it 
was the uniform practice prior to the last twenty years, to 
confide the public health of this city to the care of men 
more or less educated to the subject, a rule which since 


that period, has been completely reversed. Tbese change^ 
both from wrong to right in other cities, aud from right to 
wrong Id New York, have produced their legitimate effects : 
while in the one ca8c humau life has been saved and 
leugChenod, in the other it has been shorteaed and 

For examples, I liave already quoted from annual 
reports of the mortality of this city for the last 22 years, 
and have shown the immense loss of life which it has sus- 
tained from causes, some wholly and others partially, 
within control. 

Lot me now aak your attention to a passage from a re- 
cent paper by Dr. V. Mott Feajjcis, the worthy son of 
the worthy sire, ao long the pride of this his native city : 

" It will be neon how mnch the science has ddiie for human 
life, by a glance at the statistics of mortality of ttio groat cities 
of Europe, which have been blessed with truly acieutific phy- 
sicians, and have yielded to the mild authority of the Goddess 
Hygeia. la Paris, in the fonrteenth century, the mortality 
was 1 in 20 ; in 1830, the number of deaths was 1 in 32. 
Within a very recent period, the hyg'ienic measures resorted 
to have reduced the mortality to 1 inSli.Tl. M. Mabc d'Espike, 
in a work on ' Comparative Mortuary Statistics,' proves that 
in the sixtoonth century the duration of IJfo in Geneva was 
less than 5 years ; in the seventeenth century, II years ; inthe 
early part of the eighteenth, 21 years, and at its close, 38 
years ; at the present time it is 44 years. The population of 
Loudon in 1665 was no greater than that of New York now, 
and yet so miserable was tlic hygienic government, and so 
horrible the dirt aud slime of the city, that in that year, bo- 
sides 68,000 deaths by the plague, there were 28,000 deaths 
from all other diseases. We here bofaold a mortality frightful 


to contemplate— 1 in 24. What is the case now, since a 
thorough and proper hygienic Bupervieion has been exercised 
in that vast raotropoliB ? Longevity has been atcadily increas- 
ing, and we see, with joy, the fruit of our rew^ard, in the happy 
result which the statistics of the British capital present. One 
in 40 is the ratio at this present day. Our own country suf- 
fers, not so much from ignorance, as from the indifference of 
those invested with ofScial authority. Our Icg'islators and city 
rulers seem only to care about filling their bottomless pockets, 
and not for the lives of the thousands who perish annually 
from their avarice and gross neglect of the high duties they 
pledged themselves to perform when asking the votes of their 
fellow-citizens. Let us look at the sanitary statistics of the 
four great cities of the United States for a moment. In 1850, 
the deaths in New York averaged 1 in 33.52 ; in Philadelphia, 
1 in 3t.84 ; in Boston, the same ; in Baltimore, 1 in 3fi.l9. In 
1857, the mortality in New York increased to 1 in 27.15 ; in 
Philadelphia, it diminished to 1 in 44.5 ; in Boston, to 1 in 
39.88 ; in Baltimore, 1 in 36.19. These figures prove that 
Baltimore remained stationary (yet comparatively good) ; 
that Boston improved ; that Philadelphia improved when com- 
pared to 1850, but lost when compared to 1855, when only 1 in 
4t.81 died ; but that New York has reached almost the same 
ratio that London exhibited nearly two hundred years ago. 
The rulers of New York," continues the author, "must feel 
happy, when they retire at night to their couches of down, with 
the sweet reflection that lin 37.15 die annually in the city which 
they rule. It must gratify their patriotic aspirations when they 
see plainly that, in a few years, New York will be first in every- 
thing, even in the number of her deaths. What glory I the 
greatest city for human mortality in the world I" 

But it is in view of the queetiou which now so fearfully 
agitates the country, that this matter of Sanitary reform 
possesses a direct and overpowering interest. If the 

strength of a State consists in tlie Btalwaii; arms of its yeo- , 
manry, then, if ever, we can appreciate the value of & 
Binglelife, and wccan count at the present hour, the loss we 
have sustained by the premature burial, during the last 
twenty or twenly-five years, of 50,000 individuals, who 
should now be here to aid us in the preservation of our 
country and Constitution. 

It is told of an elderly mother in Rhode Island, 
when congratulated on her patriotism aa she cheerfully 
gave her three sous to go forth in defense of her home and 
her country, that she replied, " if she could but have antici- 
pated all this in time, she would have doubled the num- 

Oh ! if the short-sighted rulers of this city, who, 
twenty years ago, subverted the tbeu order of aiTange- 
ments which had prevailed for forty years, if they 
had but let things alone, comparatively inert as they were, 
in all probability the present race of inefficient pretenders 
to Sanitary government would have been unknown, and 
like the Rhode Island matron, we might now have had 
double the number of our country's defenders in the 
ranks from this city, when every man and woman counts 
at their true worth. 

We know not what the future has in store for us — but 
it is not impossible that another quarter of a century may 
find ua in even a worse predicament than the present. 
Would it not be an act of mere worldly wisdom, to begin 
now to save the lives of the children and youth, who 
then may be needed for the protection of the laws ? 

This, we must all admit. 

; comparison with the 


higher view of the duties of man on earth, a consideration 
which dwindles to insignificance by the side of the glori- 
ous duty which belongs to all who live — to serve their God 
with a zeal equal to that vrith which their country is now 
served; but I use it merely to illustrate the mundane 
value of every life, and how much they serve their coun- 
try who seek to save and increase its population, and how 
worse than rebels are they who, having the power, are, to 
say the least, indifferent to its exercise. 


The subject of Sanitary reform presents itself to us in a 
number of important practical aspects. In order to realize 
these in their true force, we must first ascertain what is 
the actual loss of life, over what is unavoidable. For this 
city, let us take last year's mortality as the basis of calcu- 

Oneand ahalf percent, per annum of the population is 
the standard rate of mortality in the most salubrious dis- 
tricts. Calculating from this datum, we have the follow- 
ing results for this city in 1S60 : 



If, therefore, the city of New York could last year, by 
any possibility have been brought to a natural state of 
salubrity, its population this day, would have been greater 
than it is by 10,496. That number of human beings would 
be living and animating the households, instead of mould- 
ering into dust. 

But that extreme result could have been ciTected, i 
tlie present inaladniinistratiou of imperfect laws, only by 
something akin to a miracle ; and wc will, for the present 
purpose, in our estimates of what might be done by a 
thorough application of Sanitary law, content ouraelves 
with a deduction of 50 per cent, from that number, and 
suppose we had sacrificed, by the neglect of Sanitary pre- 
cautions, only 5,248 of our fellow-creatures, and thia in a 
year of more than usual salubrity. 

There is not a reasonable doubt that these 5,948 livcB 
might have been saved. The history of Sanitary science, 
the practical results of the application of Sanitary mea- 
sures in numerous places, and under every variety of cir- 
cumstance, and the opinions of many of the soundest and 
most experienced practitioners of medicine and hygiene, 
the world over, all concur in proving that governments, 
in this particular, hold the lives of their subjects in their 
hands. It were easy to fatigue you with the recital of ' 
facts and authoritative opinions to this effect. Tho vast i 
progress made in the cultivation of a knowledge of Sani- 
tary law and its applications, during the last two cen- 
turies, forms one of the most pleasing, as it is a moat strik- 
ing, proofof the advance of Christian civilization iu modern 

We believe in the sacreduess of human life, and that its 
unnecessary waste by neglect is but one degree lower iu 
criminality than its willful destruction. Every impulse of 
honor, of self-respect, and religious duty, should impel to 
the industrious use of the most enlightened public means 
for its preservation. But, sorry we are to say it, these 
higher considerations are too apt to be overlooked by those 

who have the care of the public health, either from ignor- 
ance of the proper means, or worse still, from self-endur- 
ing blindness from the interposition of their personal and 
political interests. 

While as yet the public miud ia too uneducated, on thia 
great question, to expect a popular demand of our rulers, 
of a reform in the existing abuses of power, we may 
address ourselves to an inferior, yet to many a more potent 
stimulus, i. e., self-interest. To say nothing of the expenses 
attendant upon the sickness of those who die — of the cost 
of their funerals, the loss of their services, the loss of time 
by the surviving relatives, and the derangement of their 
private affairs — let us glance at another direct product of 
the same insalubrious circumstances which produced these 
3,974 premature deaths. 

It is estimated by Prof. Platfair that for every death in 
a community there are 28 cases of sickness, an estimate 
which, as far as I am aware, has borne the test of examina- 
tion, and stands undisputed. At this rate there were in 
this city, in 1860, 146,944 unnecessary cases of sickness. 
Each case consumed, at a moderate estimate, an average 
of not less than ten days of the patient's time, making an 
aggregate loss of 4,025 years. 

It is a good principle of law, that whoever receives a 
bodily injury on account of the neglect or carelessness of 
another, is entitled to recompense therefor. Thus govern- 
ments are obliged to keep the roads, bridges, wharves, &c., 
in good order, or to compensate for any injury to body, of 
man or beast, arising from their neglect. 

Our law libraries abound in statutes and decisions on 

this subject. Well, government also assumes the car^ 
the public health — it guarantees protection to ita depend- 
ent people, against disease-producing nuieancee. 

This city, presenting to every man, woman, and child, 
on their arrival within the bounds of its authority, its code 
of Sanitary laws, virtually says to each, " Here you may 
dwell iu immunity from danger from all causes of sickness 
or injury, except such as you may briug upon yourself, or 
tliat may be produced by the uncontrollable elements. If 
your limb is brokeu by falling into an unguarded hole in 
the public highway, we are responsible tlierefor, and will 
pay the damages." This is settled law. But does not 
government also virtually say the same of typhus fever, or 
dysentery, or erysipelas, produced by inhaling the foul 
gases from an untrapped sewer, or from the reeking masses 
of garbage which Sll the gutters, or line the sidewalks io 
huge open boxes, or the six months' accumulation of street 
filth — does it not say the same of small-pox, from whose 
pitiful ravages it might, with a little energy, protect every 
one ; and in such cases also, as in the other, should it not 
remunerate the sufferer for all the loss of time, and other 
expenses incurred ? 

I state the case simply, for it seems a self-evident propo- 
sition, needing no argument. 

On this principle, then, the account for damages against 
the government of this city, for the year 1S60, would stand 

The Mayor, Aldermen, and Coramotialty of the City of New 
York, acting as guardiaus of the Public Health, Dr. 

To H6,944 Inhabitants. 


To expenses of sictneBS, incurred by neglect to remove certain 
nuisances, and maintain the Public Health, as per agree- 
ment, including medicines, nursing', and medical expenses, 
at $20 each .$2,938,880 00 

To loss of time, 4,025 years, at $500 per year. . .2,012,500 00 


From this bill there are omitted all considerations for 
bodily and mental suffering, the expenses of funerals of the 
unnecessary dead, the grief of survivors, and the pauper- 
ism of widows and orphans. Those items, could a pecuni- 
ary estimate be made of them, would swell the amount 
to an aggregate that would be frightful to contemplate, 
but which is none the less real because divided among so 
many thousand sufferers. 

Though such a charge as this may iievei' have been 
made, or contemplated, is not the position morally sound ? 
Such a case would possibly puzzle a jury not a little, and 
our j udges might find no precedent for it in the books, but 
its equity ia none the less clear, 

We have thus demonstrated that the question of the 
public health is a question of private interest, the extent of 
which I have but feebly portrayed. 

The next aspect in which it ia presented to us is, that 
of its public interest. Every life lost (may we not add, 
every life prevented), and every day lost by sickness, ia eo 
much detracted from the strength of the State. This 
truth was, perhaps, never more strikingly exemplified than 

at the present crisis of our national affairs, wlieu vvevf 
man counts at his full value. For, 

■■ WliM PI 

Xat high-rjiised battlement, or labored moonil, 

Tbiok will, or moated gate ; 
Not cities, proud, with spires and turrets croirned ; 

Not bayii aod broad-arioed ports, 
Where, laugliing at the ntorm, rich nuvleB ridt:; 

Xot Btarred atid npnngled courti, 
Whoro low-browed bdsenosa wafla ptrfnme lo pride. 

No ! Men, hjgb-mioded men, 
WHli ponera as Tar Bbove dull brutes endiiDcl 

In rarest, brake, ur den. 
As beusla excel cold rocks, and brambles rode : 

Men who thoii daUea know. 
Bat know their rightu, and knowing dare tiiuintBin. 

{And among those rights, there is none ilearer than the 
right to live.) 

Such UMis this favored isle, 
Thsn Leiboa rnlrer, and the Cretan shore ; 

Shall Sj/gebt no more smile? 
Shall we heace langoiiili, and be mea no more ? 

Since all must liTe resign. 
The well-known roeaos which help ua it to save 

'Tia foil; tn decline. 
Andslnk antlmel; to the eilent grave." 

I have before e.vhibited the effect upon our preseut 
aviulable strength, of the neglect of the government to 
guard the lives of our population during the last twenty- 
two years, within which period have been lost at least 
50,000 lives, which, by an intelligent and faithful ad- 
ministration of the Health Department, vdghl haec been 
saved, and added to the present population, every member 
of which is, at the present moment, of direct value to the 
government itself. 


We have recently had two exhibitions of the value of 
scientific, skilled, and well-traioed energy, in the manage- 
ment of the great army which has been so suddenly called 
into existence for the protection of the Union and the 
Constitution. We all remember with what sad accounts 
our ears were daily saluted, of the undisciplined condition 
of many of the troops in and about the Capitol — of their 
irregular and depraved deportment, leading naturally to 
the disaster of July 2l6t ; and we now behold with cor- 
responding pleasure, the magical change wrought by a 
single well-informed and determined head. Had matters 
continued as before that date, disaster after disaster must 
have ensued "till all were lost." But military science, 
in the hands of a skilled practitioner, has redeemed the 
country's credit, preserved the army, and saved the 

But even the sleepless energy and skill of that young 
general would have been inade(iuate to the avoidance of 
those numerous causes of disease and death which invari- 
ably hover around masses of human beings, and are far 
more destructive than the bullets of the foe. To the well- 
directed efforts of the United States SanitaryCommission is 
the whole country indebted, in a great degree, for the present 
excellent and almost unexampled condition of health of 
the army, and it is owing to the self-sacrificing labors of 
the merabei-s of that Commission that thousands of fami- 
lies in each loyal State, are now rejoicing in tLe lives of 
their fathers, sons, and brothers, who, but for these ser\'- 
ices, would now be numbered with tlie dead, but not in 
soldiers' sepulchres. 


There has rarely been seen a more striking proof of the 
value of well-directed efforts, guided by establiehed scien- 
tific law. than is now presented in the Sanitary condition 
of the huge oiassus of men couiposiug the Union army. 

Mr. President, I believe I am regarded as something of 
an enthusiast in this matter of Sanitary reform, and the 
ability of Sanitary appliances to save life. I confess, there- 
fore, a pleasure in an occasional observance of a more than 
confirmation of the views I entertain, by those who, I 
know, possess the fullest confidence of the general and 
acientiOc public ; as thus ; 

In a communication addressed to the various Life 
Insurance Companies, by the United States Sanitary 
Commission, dated June 21, 1861, occurs the following 

language : 

" We can do a vaH loork, in a short time, if we have lAundaiU 
means. $50,000 u-ould, we mviuudy think; enable ua to save 
50,000 livex." 

And in a general " Circular asking contributions," dated 
the next day, tliis opinion is reiterated, with a refinement. 
They say : 

"It is supposed tliat $50,000 could be expeuded with the 
greatest advantage, during the present year, in the work of 
the Commission, and that every sintjle dollar so t-penl would save 
on, lifer 

Does this language appear extravagant V I appeal to 
the facts — the results of that Commission's public agitation 
of the subject, and theii' direct official labors at the camp 
and in the fortress. When and where was ever such a 
host collected, and kept for months together, with so little 
mortality from natural causes? 


; ia seven months this day since the capitulation of 
Fort Sumter, and we have seen an army of 500,000, col- 
iected from city, farm, and factory, and put in the field 
with scarcely an idea on their part of the insalubrious in- 
fluences wliich are the invariable accompaniments of such 
gatherings. Providentially there sprang into existence, 
almost Bimultaneonsly, and hovered like a protecting 
angel over the camps of these devoted citizens, this Sani- 
tary Commission. Its effects are seen and felt in the un- 
paralleled sanitary condition of the hosts it has labored to 

It cannot, of course, be demonstrated to the letter, that 
their aoticipation of one life being saved for every single 
dollar expended, has been realized, bnt no one entertains 
a doubt that every dollar placed in their hands has been 
honestly and judiciously expended, and has brought good 
fruit. For one, I have no doubt that whether that Com- 
mission has expended 550,000, or only one-fiftli of the 
sum, it will be found at the end of this contest, that by 
their influence (and they are without power to enforce their 
precepts), upon the army and the people, they will have 
redeemed their quasi pledge, and saved 50,000 lives. 

Contrast this with the condition of the comparatively 
little army of Great Britain in the Crimea, during the seven 
months beginning Oct. ], 1S54. At no time did the nu- 
merical strength of that anny reach 30,000, and yet within 
the period mentioned there occurred over 10,000 deaths 
from disease. They then had no Sanitary Commission 
there, nor had they profited by tlieir experience since Wel- 
lington wrote to Gen. Fane in ISIO : 

" I wish I haditinmypowertogive you well-clothed troops, 
or to hang those who ought to have given them Iheir clothing." 




Thene terrible results of inattention to tlie liygienift ' 
wants of the army having aroiiBi'il the home Government 
to the performance of its July, a well-qnalified Sanitary 
Comniisaion was, in the following year, organized and 
dtapatciied to the seat of war, and in a few months the 
value of Sanitary law and practice was demonstrated hy 
a reduction in the mortality of the troops, from 28.82 per J 
cent, to one-half of one per cent.* 

•For the following brief FjnopgiB of the repnlls of tbe operallonB oTtli* I 

Brilibh Sinltary CummiEaion in tiie Ciimta, 1 urn itiilebted to Eueiu H^aus, | 
M. D., ui active member at the Cnited Slates Sanilnry Comml^ioii. 

The fotloirinB tables exhibit the total and comparolive etatintics of lickaes* I 

and tnarUlitf in Ibi! BrillBh Army in the Crlmertn csmpnlgn, snil Uie rate per I 

cent, of the diseases and deatha of all the farces, for 1st. A period of eiz nuiatbi 1 
just previous to and at the commencement nf ttie works of the Sanltar/ Commii- 

BioD, viz.: from January to June, 1855 ; nnd. 2d. A iicrlod cf six montha, f^m I 

Juiutiry to Jnne, 1^6. after those works for Sanitary improvement had prodused I 

Uietr lesllimate results. [All slcknesa and deaths In the Medical Slaff, amonK I 
Commisdaued OfDecrs, the Land Transport, and the Haunted Corpe, ni 

ne nil marlini mounds or deaiht in battle, are exuluded n-om these lablea; I 

also nearly S.ODU cases of eiekneas that foiled u> be pioperly registered due- | 
ing the eaily period of the campaign.] 





"■■■""' "'"""" 






■' LlUJtl.'S OI trie LUDHS. 






" UJcarsand DolU 

" AIluUicrdSxuii3«B.... 


— .M 
— M 

THiI number afeiKs. 







ThM the fact is demonstrate rl, by the moat unerring stftUaCics, that iluritis the I 
period beginning eight months alter the commencemeut of reforms by tbe Satii- f 


Instinctively in the mind arises the question, If ao much 
excellent Sanitary work can be done with bo little means 
among so incongruous and unsettled a mass as an army in 
the field, why may not the same good result be secured in 
a settled city t What is this city but a huge cam^i^with 
these diiferencea, that its inhabitants do not live under thin 
canvas roofs, are not packed quite so much like herrings 
in boxes, and possess domestic means of purification, ven- 
tilation, &c., which the soldier knows not of ? But wo have 
seen that instead of a saving of 50,000 lives, tliero has been 
a waste of at least that number in the hist twenty-two 
years in this city — anil that 5,000, at tlio very lowest 
estimate, were thrown away last year. What is tJie sys- 
tem of government which suffers this shocking loss, and 
what its pecuniary cost? — iu other words, what do the 

tar; Cammiaainn in the Crlnii'a. the rule or alc^kiieu in Ilia iriiiy wnn ruiluaed (u 
less than one-third or that nhirh prcv&jled until tliuiwi rofiirJiia ve-re iiiuusu rated, 
the exactratJD of thatdeereaae bslaguISSUto tn, or JjJ 1 wlillo tliu luorlalU)' 
—which ia the more nigiiiHaftot Mut of tiit uUlllj' of Hanluiry luiiirovenianlii— 
presents the marreloiu contrast a( 2SM to - .$, or STM to lUO II I^ii Ihnn one 

It 1> irorlhy or remark that, while the atatbljes abuw thitt ounaltlerable alok- 
negg contiDueil to prevail during the latter or Improved perlud, liie reoorda oftlie 
Arm; HoipitalA exhibit the Tact tbat the partJcalar diacuaea that were motl 
renarluMy riimiauli&i were thuae which Banitary uaaaareii ara known lo pre- 
vent or greatly diminhili, viz., Uie Kymoiic dlMMCa, aucb »a ttvan, and tboae 
tsaladiea that are «o largely represented in the iEal given In the foregoing Tahla. 

That this woailerful improveiueot tu h«alllj, which was the aalvatlou or tlis 
British forcea in llie Crimes, waa direeU)' an<l puaitlvnly dupenduut upou Sani- 
lory teorfci and prevenllte kygienU meaaurti, la a faat uiinfeaaed uliba Ii/ tiia 
Biilllary and medical offlcera of thoae forcea, 

And la farther corroboration ot that raj;t, it aiioDld be atuteil tliat while the 
Brilieb (roups irere thai beio); reecued from the fatal dlauitaea (hat had Ihreitl- 
eoed to make their eoeampuient a Golgntha. the French cumpa. though lucatvd 
more bvorably, and wllhla a rifle'a range of tlie Britiah, cooliiiued to grow mure 
and more sickly duriag all the iJiue of tlie grand improvement in tJie campa ot 

people of this city pay annually in money for this eelF 
destruction ? 

The answer to the first of these questions lius been given 
in the publications of this Association, and repeated in 
official legislative documents, and need be alluded to here 
only in connection with the answer to the last question. 

By the Charter, that branch of the City Govenunent 
which has " cognizance of all matters affecting the Public 
flealth" is tailed the City Inspector's Department. 

In addition to this, the statute law gives us two other ' 
organizations for this same purpose : Ist. A Board of i 
Uealtk, composed of the Mayor, Aldermen, and Council- 
men (which has had no iiiet'ting for nearly a year) ; and, 
2d. A body called CommUaiumrs nf HcaUh, compost'dofax 
persons, three of whom form parts also of the organizations 
previously mentioned, and which performs the same rela- 

Ihclr alliiiB. In the latter, the best Sanitarj- regnlaliqnB were introdoced Uid 
rigidly enfDrced by a. Sanitsry Board, while in the former (the French cBinps) 
auoh regulations were alterly neglected, " nntil," as a dlatingui^hed liiatoriui sf 
Ibe irar hui said , "with the Froncliariiiy.peaeebfcainea taUitary neccuttn." 

The Crimean Sanitaut Coxkiehios coaaiited of three gentiemen, vii., Or. 
^iniiKRLikKD, I)r. MiLKOT, Slid Hi. Rawlensdn, u civil engineer. SaA ^ ' 
tlitse Gnrtmiaiiionera had, for aeoerai yeart, iitade Sanitary Science, and ^ 
applicatioia, a special aludy. Tliey proceeded to the Crimen in April, 186S, 
taking with thoui niiwarda of thirty aldllod aaaiatuntj and laborers, toReOwr 
with Buch implement! and apparatus as tliey knew would be reijuired In the 
ventilatiun and sewerage of hosijllals anil barracks, the clcuu^ing and draioage 
of encanipments, and the parifioation or disinfectioa of trazieporta aod ahEpH. 
AtaoHg these means were pipe tubing, drainage -pip as, fitters, ten UiouHnd 
Bqusra feet of perforated »lno plated for veuUlatlou, Mnges, pulli^s, wlDdow 
fixtures, a ship load of pent charcoal, etc., etc. Inuncdiatcly upon arrival OB 
the Bospborua and in the Crimea, tbc Sanitary works were commeaeedl 
Srst by thorough cIcaoBlng, both witbin and without, the hospitals, barracbt, 
OkUd teata, aaii in these wurlo tiQirly uue handred men ircre employed for 
many montlis ; old sewers were cleaned and Hushed ; new drains were mnde ; ' 
surface filth, refuse, and decaying materials, by thouaanda of earUoadi, were 


tire service in regard to tiie public health, as would a fifth 
wheel in the progression of a coach. 


1 the 


of these three institutions i 
found in the Annual Report of the Comptroller for that 
year. An examination of the pages of that interesting 
volume shows that there were paid on their account, 
independent of the cleaning of the streets. .£153,249 35 

and for street cleaning 325,371 37 

making the total cost of (I had like to have said, for the 
maintenance of the public health) 8478,620 72, 

Here then, in the national service, is a body of citizens 
asking only S-50,000 to save 50,000 lives, which otherwise, 
in all probability, would be lost ; and in the municipal 
service, three separate organizations, spending almost ten 
times that sum, and j/cmtiiting (which is next to causing) 
the annual loss of 5,000 lives, which ought to be pre- 

With the statement of one othei fact ^vhl h to every 
intelligent mmd is sufficient to account for this heart sor 


removed, a d 1 T W 

Id lb ei 

dw i ply 

covered w th d f tb 1 p t 1 


1 tt te 

P K dtb 

water Bupplj w I d d I 

u d 

th t t i 

were rigidly p Ud d p iB d 


b d t pily 

r t h d 

I h 

] tal d ! p d f 

praoUcahlB th d t d g ral ml 


f h Idi rs w 

mp d 

The res Its f tii pi d 1 


I b t 

h d th w Id 

though Saiul y li 1 j p 

<l d Its d 

t p pb d 

]iut such r Ita 

Sajs MiB N It 1 tb 

wh 1 

p m t f 


meat npoE 1 1 1 


h d tb first 

m th r 

the Crimea mpaig m tolily 

f 60 

P t P 

g th 

troops from disBoie aio e . 

had m the last si. 

. m.ntha a mor 

tality not much greater than among o 

ur he 

nlthy Gaarda at h. 

,me." The rate 

of mortality doriag this last period o: 

r the 

1 2i per cent, of 

the whole roroe. 

rowing diiTtirencG between our uational and muoicipal 
Sauitary afloirs, I take leave of this branch of the subject. 
That fact is thia ; 

The United States Sanitary Commission consists of fifteen 
individuals, of whom seven are physicians, known to all 
as having already earned distinction in their profession — 
two are clergymen of high repute in theirs — two are dia- 
tinguiahed officers of the Army — and the rest are men 
whose fame as philosophers and civilians, is world-wide. 
They are assisted in their labors by three or four secre- 
taries, a uiBJority of whom are also able graduates in 

After this picture, how shall we bear to look upon the 
other ? But I beg your patience, while I briefly, but truth- 
fully, portray its absurd contrast : 

lu the City Inspector's Department, arc 138 individuals. 

In tlie Board of Health " 42 

In the CommisBioners of Health " 3 extra. 

Making a total of 183 

Of the three extra Commissioners of Health, one is i 
distinguished surgeon, one a retail apothecary, and the 
other the Health Officer, residing on Staten Island. Among 
the members of tbe Board of Health, there is not to be 
found oue medical man — such would be strangely out of I 
place — while of the remaining 13S attaches of the City i 
Inspector's Department, there is but one laying any clium I 
to a knowledge of medical science, and he is but a clerk, 
without any executive functions. 

Among the subordinates of the City Inspector are twen- 



ty-two Health Wardeus. "Were these important offices 
occupied as they should be, and aa they would be under a 
proper system, by men of education in Sanitary law, of 
conacientious regard for and devotion to their duties, as is 
the case in almost every other large city, how difTerent 
would be our records of mortality. But who are the in- 
cumbents? Judge ye what chance we have for improve- 
ment in the public health, as I recite, from a recent legisla- 
tive report,* the occupations of these Health Wardens in 
1859. Of the twenty-two, 

1 was a clerk, 2 were house carpenters, 

I a speculator, 1 a, barber, 

1 an emigrant runnei 

1 a barkeeper, 

1 ■ a policy dealer, 

1 a plumber, 

1 a stone-mason, 
. 2 were bricklayers, 

I a sliip carpenter, 

In 1861, the political necessities of somebody (not the 
Sanitary interests of the city) required that each Health 
Warden should have an Assistant, with the same com- 
pensation, 81,000 per annum, bo that the public treas- 
ury is now depleted yearly, for these men, of $44,000, 
without any return. This office of Assistant Health War- 
den Las been created without a shadow of reason, and as to 
their capacity for Sanitary service, we have only to say, 
they are the equals of their superiors — in each Ward "par 
nobile fratrum." 

3 were rnmsellers, 

1 a cartman, 

I a butcher, and 

1, until his appointment as 
Health Warden, had uo 
bus i lie 8 9 wccupatioi). 


if tlie oilj of New York.-Senuti 

apiiiilnted to InTestigatc the IlcaUli DcpiLrt- 



There are two principles which lie at the fouadation of 
all true Sanitary arrangements, and which cannot properly 
be overlooked in the construction of any systeui, whose 
object is the most thorough and efficient protection of the 
people against diseases of every kind. 

The first of these principles is, that it is the whole people 
who are to be thus protected — not merely one word, one 
section, one city, or even one State — and if it is designed to 
do the whole work of Sanitary protection, the whole coun- 
try should be embraced witliin the sphere of its operations. 
For we must remember that while there are many disor- 
ders which afSict humanity, of purely local origin, and 
circumscribed in the extent of their action, and benee 
removable or preventable at their immediate source, there I 
are others which know no limits, spreading over large areas 
of country, and comniunieable from person to person, by 
clothing, by merchandise, by vehicles, or by atmospheric 
currents. On this and other accounts, the scope of opera- 
tions of a Sanitary system shoukl be coextensive with the 
population ; the political and Sanitary government should 
progress side by side, and hand in hand. i 

If therefore it were possible, our National Government 
should establish a Sanitary Board, like that now in oper- 
ation in Great Britain, whoac protecting arm is spread 
over every section, with one central head. The close 
intimacy and free intercourse which characterize us as 
a social and commercial people (I speak of what was, 
and what, I trust and believe, will be restored), bring- 
ing together in daily and hourly intercourse the inbab- 

itanta of widely diverse climates and Busceptibilitiea, 
demand that there should be eome common regu- 
lator of that intercourae, for the protection of all alike. 
But it has been decided by liigh authority, that the mat- 
ter of Healtli Police is a reserved State right, and that 
national laws governing the commercial intercourae of 
the people, niuat yield to those of the several States in 
this particular. 

To the State, then, we turn, for the next most effective 
general arrangement ; and whether we regard the source 
of power, or the unity of the people's interest, it is clear 
that any system of Sanitary protection, to be full and 
complete, should cover the entire area of the State, from 
MoDtauk to Niagara. 

Local subordinate ageuciea, or Boards of Health, are of 
course neceasary for the immediate care of the separate 
localities, but there should be an authority, superior uud in- 
dependent, for the ayatematic government of the whole ; 
tor action in those cases in which two or more localitiea 
are interested, as in the draining of extensive marshes, the 
regulation of intercourse between infected places, the in- 
fluence of building dams, railroads, and public institutions, 
&c., and for appeal in cases of dispute between conflicting 
interests. As evidence of the importance of this latter, I 
may cite a few instances. 

In a certain part of this city exists a very extensive and 
seiious nuisance, against which the neighbors complained, 
and succeeded in obtaining an order for its abolition from 
the Board of Health. In a week or two the decision was 
reveraed, and the nuisance contitiuea, through, as is believed, 
the political and pecuniary influences of the owners. 




mce waa seen io the result of the invee 
gation into the cliaracter of the awill luOk factories iu thjfl 
city, in which, contrary to the opiQions of some of the souiid- 
cBt merabere oi' tlie medical profession, and the recital of 
numerous cases of injury froiu tlie use of their products, a 
local and purely political Board of Health decided there was 
uo harm from them. 

Another case is described iu the following note from 
the physician of a 8tate lustitiitiou, which is threatened | 
with a serious insanitary nuisance : 

I.uN'ATic AayLUM, ) 
AuBniis, Out. la, IfeOl. J 
Dear Sir ; Will you please give me your opinion of the 
propriety, in a Sanitary view, of building pig-pens for over I 
one hundred hoga, to occupy one-half acre of the walled yard f 
(wall fourteen feet high), containing five acres appropriated I 
for the use of this Aaylum. The hogs to bo fed with the refuse I 
from the State Prison. 

! within two hundred feet of the n 

n the side from wliich the wind ' 

Said pig-yard to 1 
building of the Asylut 

I am very truly yours, 


It may readily be perceived how important and valuable 
would be au independent Board of Appeal, of scientific 
character, in all such cases. 

But supposing this desideratum of a Stale Sanitary 
Board unattainable, the New York Sanitary Association 
baa suggested the next best step. It has proposed to unite | 
all the territory and population surrounding our beautiful I 
bay aud harbor, within the bounds of our State, into I 
one district and one people, for their Sanitary government, , 


aa they are, in fact, one politically, commercially, socially, 
and by every temporal interest — especially in their expo- 
sure to one great source of disease from abroad, through 
the vessels at Quarantine.* 

To this wholesome and just measure there has ever 
been but one objection, and that from one quarter only, 
viz. : The office-holders of the City Inspector's Depart- 
ment, whose sinecure salaries give them power and leisure 
for a most unequal contest. 

The scco«(/j7j'(nci^fc which we claim as essential is, (he 
jrrojKT education of every Sanitary officer: No intelligent per- 
son, who reflects a moment upon the vast variety of sub- 
jects included in tho idea of Sanitary regulation, but must 
admit that there is scarcely another branch of public ser- 
vice demanding so varied a knowledge. 

" The Officer of Health must himself be thoroughly in- 
formed of all the circumstances which affect the health of 
man, not only in his isolated condition as an individual, 
but in his social condition, and in his state of 8 

" Preventive medicine, while it constitutes a special, is 
itself the highest and most useful, branch of medicine, and 
requii-es in its missionaries a correspondingly long and 
special study, to become useful promulgators of its doc- 
trines, and workers in its cause."f 

Although this proposition is too self-evident to require 
further comment, we find in a recent public document, 
emanating from the health department of this city, over the 

name of the City Inspectoi',* tlie liilliiwitig aRMiirtion atitl 
opinion, which cannot be allowed to pass without their 
reriitation, and with which I close : 

'' On anosumination of the public records of the City Inspect- 
or's tifflce, when adminietered under the snpervisioii of in- 
spectorB of the medical profession, I have not been able to 
discover a single sanitary improvement, or even a practica] 
suggestion, as coming from them in their repoi'ts to the Com- 
mon Council" ***** * 
" and a merely medical man might find, in the discharge of his , 
dutiee, a necessity for (|ualitiee whiuh an education solely 
medical would poorly supply." 

The author of those seiitenccB has read the history ' 
neither of his department nor his country, to much pur- 
pose. Among many other instances that might be cited, 
let me inform him, in regard to the first of tliiise stote- j 
ments, that one of the most important of tlie laws now 
governing that department, that which prohibits the re- 
moval of the dead from the city without a permit, whereby 
alone the records of mortality can be made up, was the 
suggestion solely of one of his medical predecessors, made , 
nearly twenty years ago, and by liim was its enactment 
obtained in spite of the veto of the then Mayor, 

And in reply to the insinuation, that a medical education 
is incompatible with "practical abilities and common 
sense qualifications," I recommend him to read the history 
of Bunker Ilill, where, at the head of a noble band, con- 
tending for the liberties we are now enjoying. Doctor 
JosKPit Warbejj yielded up his life. 

I point him, also, to that eminent physician, who, while 
* Coannmilcnlion [o llie Charter Cnmeiitinn. 


serving as surgeon to a regiment in Mexico, finding, on 
one occasion, all his superior officers disabled, unhesita- 
tingly placed himself at the head of the troojis, and by his 
skill and courage won the day. Returning to his home, 
the uncertainty of the fate of Sir John Franklis fired his 
adventurous spirit, and he who had won honors aa a sur- 
geon and a martial leader, now became the gallant navi- 
gator of the Polar seas, and in the memory of all high- 
minded men, the name of Doctor Kanh will live forever. 

And yet again, as if onhj in the ranks of the profession 
could be found a sufficient amount of " practical ability 
and common sense," this city is honored this day with 
the presence of his worthy successor, another distinguished 
Ai'ctic explorer, Doctor Hays. 

And finally, I point to Doctor Simos, one of the most 
distinguished physiologists of Great Britain, and Chief 
Medical Officer of Health of the city of London, the mag- 
nificent results of whose administration of the Sanitary Laws 
of that metropolis furnish ample evidence of the neceisitij 
of a thorough medical education in the head of a lieaitli 
department, and who has given us these words, preg- 
nant with truth and wisdom : 

" Pkeventive medicine will effect infinitely more for mankind 
than all the drugs which have yet been discovered, and all the 
curalioe ^kiU xohich has ever been everted for Iht' allevialion of 

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